MEDICARE: GARY F BJARNASON

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
1	213EP1101X	Primary Podiatric Medicine Podiatrist	237	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	243143	OTHER		MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0801G	OTHER	NC	BCBS OF NC
2	77489	OTHER		MEDCOST
3	4545795002	OTHER		CIGNA
4	480033405	OTHER		RAILROAD
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821192154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY F BJARNASON

Provider Business Mailing Address
First Line	:	240 SMITH CHURCH RD
Second Line	:
City	:	ROANOKE RAPIDS
State	:	NC
Zip	:	27870-4903
Country	:	US
Telephone Number	:	252-535-2004
Fax Number	:	252-535-9154

Provider Business Practice Location Address
First Line	:	240 SMITH CHURCH RD
Second Line	:
City	:	ROANOKE RAPIDS
State	:	NC
Zip	:	27870-4903
Country	:	US
Telephone Number	:	252-535-2004
Fax Number	:	252-535-9154

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2006
Last Update Date	:	12/21/2008

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Directions to “ GARY F BJARNASON ” Practice Location

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