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NPI Code Detail

MEDICARE: ANTHONY G PATRIARCO MD

MEDICARE: ANTHONY G PATRIARCO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician0101044698VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
144482OTHERVAOPTIMA
2700028144OTHERVACIGNA
35862736OTHERVAVA PREMIER
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5148137OTHERVASOUTHERN HEALTH
6231695OTHERVAANTHEM

General Provider Information

NPI Number : 1194799973
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY G PATRIARCO MD
Provider Business Mailing Address
First Line : 213 S JEFFERSON ST STE 1006
Second Line :
City : ROANOKE
State : VA
Zip : 24011-1713
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 911 E MAIN ST
Second Line :
City : FLOYD
State : VA
Zip : 24091-4183
Country : US
Telephone Number : 540-745-2031
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2006
Last Update Date : 12/21/2023

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Directions to “ ANTHONY G PATRIARCO MD” Practice Location

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