Individual
MICHAEL PATRICK JEREMIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
390 S MAIN ST STE 201, ROCKY MOUNT, VA 24151-1767
(540) 484-4800
(540) 484-4847
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101052753
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080102543
MEDICARE RAILROAD
VA
05
—
5615313
—
VA
05
—
5635179
—
VA
Enumeration date
10/20/2005
Last updated
12/18/2025
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