Individual
DR. BARRYTON DECRUSE WAANBAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
(540) 853-0931
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101257658
VA
208M00000X
Hospitalist Physician
2019-02459
NC
Other
Enumeration date
07/12/2011
Last updated
08/11/2022
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