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General NPI Number Information
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NPI Number | 1497622575
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Entity Type | Organization
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Legal Business Name | SWVA PREMIER PEDIATRICS & INTERNAL MEDICINE, PLLC
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Dates
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Enumeration Date | 10/22/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1728 PARK AVE NW
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City | NORTON
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State | VA
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Zip | 24273-1613
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Country | US
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Telephone | 276-220-8861
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 126
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City | NORTON
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State | VA
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Zip | 24273-0126
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAMUEL P. DEEL
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Credential |
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Telephone | 276-220-8861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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