Organization
HALIFAX MEDICAL SPECIALISTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERARDO M MARADIAGA MD (SECRETARY TREASURER)
(252) 537-0134
Entity
Organization
Contact information
Practice address
270 SMITH CHURCH ROAD, ROANOKE RAPIDS, NC 27870-4914
(252) 537-0134
(252) 537-6515
Mailing address
270 SMITH CHURCH ROAD, ROANOKE RAPIDS, NC 27870-4914
(252) 537-0134
(252) 537-6515
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01746
BCBSNC
NC
05
—
8901746
—
NC
Enumeration date
11/13/2006
Last updated
08/22/2020
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