Organization
MOUNTAINEER GASTROENTEROLOGY INC
Active
Organization
MOUNTAINEER GASTROENTEROLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS B CORTELLESI DO (OWNER/PRESIDENT)
(276) 596-9980
Entity
Organization
Contact information
Practice address
1100 CEDAR VALLEY DR,, CEDAR BLUFF, VA 24609
(276) 596-9980
(276) 596-9981
Mailing address
4035 COLLEGE AVENUE, #102, BLUEFIELD, VA 24605
(276) 596-9980
(276) 596-9981
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
0102037199
VA
207RG0100X
Gastroenterology Physician
1732
WV
Other
Enumeration date
09/26/2007
Last updated
09/21/2010
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