Healthcare Provider Details

I. General information

NPI: 1487891933
Provider Name (Legal Business Name): APPALACHIAN REGIONAL MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2009
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 PARK AVE
BANNER ELK NC
28604-6604
US

IV. Provider business mailing address

155 FURMAN RD SUITE 7
BOONE NC
28607-5049
US

V. Phone/Fax

Practice location:
  • Phone: 828-262-9127
  • Fax: 828-268-0742
Mailing address:
  • Phone: 828-262-9127
  • Fax: 828-268-0742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number33815
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number31158
License Number StateNC

VIII. Authorized Official

Name: MS. MARY ETTA LONG
Title or Position: SR. VP MEDICAL STAFF RELATIONS
Credential:
Phone: 828-262-4133