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Organization

CARDIOTHORACIC SURGEONS OF ROANOKE VALLEY LLC

Active
Other names
Cardiothoracic Surgeons of Roanoke Valley
Organization subpart
No

Provider details

NPI number
Authorized official
BUDDY BLACKWOOD (VP)
(540) 772-3527
Entity
Organization

Contact information

Practice address
1802 BRAEBURN DR, SUITE 1310, SALEM, VA 24153-7357
(540) 776-2029
(540) 776-2017
Mailing address
1802 BRAEBURN DR, SUITE 1310, SALEM, VA 24153-7357
(540) 776-2029
(540) 776-2017

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1346343563
VA
Enumeration date
09/06/2006
Last updated
02/07/2008
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