Organization
ROANOKE FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA LYNN BOWMAN (OFFICE MANAGER)
(252) 384-0154
Entity
Organization
Contact information
Practice address
902B ROANOKE AVE, ELIZABETH CITY, NC 27909-5565
(252) 384-0154
(252) 335-2731
Mailing address
902B ROANOKE AVE, ELIZABETH CITY, NC 27909-5565
(252) 384-0154
(252) 335-2731
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DO2435
RAILROAD MEDICARE PIN
—
Enumeration date
10/15/2008
Last updated
05/11/2010
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