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Individual

DR. LOUBNA T SCALLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1111 S JEFFERSON ST STE B, ROANOKE, VA 24016-4724
(540) 769-3964
(540) 342-2193
Mailing address
PO BOX 8310, ROANOKE, VA 24014-0310
(540) 345-3556
(540) 342-2193

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME156131
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
0101276310
VA
2085R0001X
Radiation Oncology Physician
01063079A
IN
2085R0001X
Radiation Oncology Physician
21776
WV
2085R0001X
Radiation Oncology Physician
MD2012-0012
NM
208D00000X
General Practice Physician
MD2012-0012
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000506581
ANTHEM PROVIDER NUMBER
IN
05
200851560
IN
05
3810001728
WV
01
9365920
PHCS PID NUMBER
IN
05
95220771
NM
01
NPI & TIN
BCBS OF NM
NM
Enumeration date
03/23/2006
Last updated
01/23/2023
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