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General NPI Number Information
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NPI Number | 1568785376
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Entity Type | Organization
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Legal Business Name | HORIZON MED INC
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Dates
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Enumeration Date | 03/08/2010
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Last Update Date | 04/19/2010
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Provider Practice Location Address
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Address Line | 4950 BRAMBLETON AVE UNIT B
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City | ROANOKE
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State | VA
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Zip | 24018-4119
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Country | US
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Telephone | 540-353-0927
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Fax | 866-788-8223
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Provider Business Mailing Address
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Address Line | 4950 BRAMBLETON AVE UNIT B
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City | ROANOKE
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State | VA
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Zip | 24018-4119
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Country | US
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Telephone | 540-353-0927
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Fax | 866-788-8223
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Authorized Official
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Title or Position | PRESIDENT
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Name | MUKESH PATEL
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Credential | M.D.
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Telephone | 540-353-0927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101035881
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License Number State | VA
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