MEDICARE: DR. ARTHUR SAMUEL PEMBERTON M.D.

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	207R00000X	Internal Medicine Physician	0101058049	VA

General Provider Information

NPI Number	:	1578533873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARTHUR SAMUEL PEMBERTON M.D.

Provider Business Mailing Address
First Line	:	213 S JEFFERSON ST STE 1006
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24011-1713
Country	:	US
Telephone Number	:	540-224-5715
Fax Number	:

Provider Business Practice Location Address
First Line	:	544 E STUART DR STE D
Second Line	:
City	:	GALAX
State	:	VA
Zip	:	24333-2231
Country	:	US
Telephone Number	:	273-236-5181
Fax Number	:

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

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	08/12/2022

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Directions to “ DR. ARTHUR SAMUEL PEMBERTON M.D.” Practice Location

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