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NPI Code Detail

MEDICARE: DR. BONNIE CULKIN M.D.

MEDICARE: DR. BONNIE CULKIN 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
1207Q00000XFamily Medicine Physician0101053171VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4080120085OTHERVARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23291137OTHERVACIGNA
3324497OTHERVAANTHEM
5313123OTHERVASOUTHERN HEALTH
65361306OTHERVAAETNA

General Provider Information

NPI Number : 1982642930
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BONNIE CULKIN M.D.
Provider Business Mailing Address
First Line : 4461 STARKEY ROAD SUITE 201
Second Line :
City : ROANOKE
State : VA
Zip : 24018
Country : US
Telephone Number : 540-345-4946
Fax Number : 540-982-7164
Provider Business Practice Location Address
First Line : 1421 3RD ST SW
Second Line :
City : ROANOKE
State : VA
Zip : 24016-5204
Country : US
Telephone Number : 540-345-4946
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2006
Last Update Date : 03/10/2026

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