Organization
MEDVANTAGE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE L REDELSPERGER (ADMINISTRATOR)
(704) 489-2401
Entity
Organization
Contact information
Practice address
294 HWY 16N, STE C, DENVER, NC 28037
(704) 489-2401
(704) 228-0009
Mailing address
294 HWY 16N, STE C, DENVER, NC 28037
(704) 489-2401
(704) 228-0009
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133E0
BCBS
NC
05
—
89133E0
—
NC
01
—
DA7558
RAILROAD MEDICARE
NC
Enumeration date
04/26/2007
Last updated
10/29/2015
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