Organization
ROANOKE EAR NOSE & THROAT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY T HARTER MD (PRESIDENT)
(540) 345-3556
Entity
Organization
Contact information
Practice address
201 MCCLANAHAN ST SW, ROANOKE, VA 24014-1709
(540) 345-3556
(540) 342-2193
Mailing address
PO BOX 8788, ROANOKE, VA 24014-0736
(540) 345-3556
(540) 342-2193
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
0101044826
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
065839
ANTHEM
VA
01
—
CM5366
RAILROAD MEDICARE
VA
Enumeration date
07/18/2006
Last updated
08/22/2020
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