Healthcare Provider Details

I. General information

NPI: 1366973042
Provider Name (Legal Business Name): NATHANIEL LINGER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2017
Last Update Date: 05/06/2021
Certification Date: 05/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1906 BELLEVIEW AVE SE CARILION ROANOKE MEMORIAL HOSPITAL
ROANOKE VA
24014-1838
US

IV. Provider business mailing address

221 EDGEWOOD RD S
ASHEVILLE NC
28803-1862
US

V. Phone/Fax

Practice location:
  • Phone: 540-981-7000
  • Fax:
Mailing address:
  • Phone: 828-507-7467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101267429
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: