Healthcare Provider Details

I. General information

NPI: 1437737962
Provider Name (Legal Business Name): NATHANIEL RICHARD RODDENBERRY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 HENDERSONVILLE RD
ASHEVILLE NC
28803-2868
US

IV. Provider business mailing address

123 HENDERSONVILLE RD
ASHEVILLE NC
28803-2868
US

V. Phone/Fax

Practice location:
  • Phone: 828-771-3545
  • Fax: 828-232-2942
Mailing address:
  • Phone: 828-771-3545
  • Fax: 828-232-2942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number344189
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: