Provider Demographics
NPI:1144567272
Name:TE, ROLYN PASTER (MD)
Entity Type:Individual
Prefix:DR
First Name:ROLYN
Middle Name:PASTER
Last Name:TE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:105 W STONE DR
Mailing Address - Street 2:SUITE 6A
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-3365
Mailing Address - Country:US
Mailing Address - Phone:423-408-7220
Mailing Address - Fax:423-408-7405
Practice Address - Street 1:851 LOCUST ST
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37857-2407
Practice Address - Country:US
Practice Address - Phone:423-272-2671
Practice Address - Fax:423-272-7067
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2019-00192207R00000X
TN50116207R00000X
VA0101253706208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVVB139BMedicare PIN
TN103I115710Medicare PIN