Organization
INTERNAL MEDICINE OF BLACKSBURG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH WASHINGTON (VICE PRESIDENT)
(703) 650-2907
Entity
Organization
Contact information
Practice address
3698 S MAIN ST, BLACKSBURG, VA 24060-7015
(540) 951-6070
(540) 951-6071
Mailing address
3698 S MAIN ST, BLACKSBURG, VA 24060-7015
(540) 951-6070
(540) 951-6071
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316985070
—
VA
01
—
DF5833
RR MEDICARE
—
Enumeration date
06/03/2006
Last updated
04/20/2008
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