Provider Demographics
NPI:1053634873
Name:ROANOKE PARTNERS IN HEALTH, PC
Entity Type:Organization
Organization Name:ROANOKE PARTNERS IN HEALTH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MALINCHAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-904-7912
Mailing Address - Street 1:3239 ELECTRIC RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-6444
Mailing Address - Country:US
Mailing Address - Phone:540-904-7912
Mailing Address - Fax:540-904-7926
Practice Address - Street 1:3239 ELECTRIC RD
Practice Address - Street 2:SUITE A
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-6444
Practice Address - Country:US
Practice Address - Phone:540-904-7912
Practice Address - Fax:540-904-7926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-08
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101-055326261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care