MEDICARE: DR. BRIAN ARTHUR ROVIRA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	MD0000043266	TN

General Provider Information

NPI Number	:	1013165125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN ARTHUR ROVIRA MD

Provider Business Mailing Address
First Line	:	PO BOX 459
Second Line	:	850 MARBLETON RD
City	:	UNICOI
State	:	TN
Zip	:	37692-0459
Country	:	US
Telephone Number	:	423-743-7970
Fax Number	:	423-743-7970

Provider Business Practice Location Address
First Line	:	850 MARBLETON RD
Second Line	:
City	:	UNICOI
State	:	TN
Zip	:	37692-0459
Country	:	US
Telephone Number	:	423-743-7970
Fax Number	:	423-743-7970

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	01/29/2016

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