Provider Demographics
NPI:1275613473
Name:ENDOCRINOLOGY ASSOCIATES INC
Entity Type:Organization
Organization Name:ENDOCRINOLOGY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:H
Authorized Official - Last Name:BIVENS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:540-344-3276
Mailing Address - Street 1:3501 COLONIAL GREEN CIR SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-3752
Mailing Address - Country:US
Mailing Address - Phone:540-344-3276
Mailing Address - Fax:540-342-4399
Practice Address - Street 1:3501 COLONIAL GREEN CIR SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3752
Practice Address - Country:US
Practice Address - Phone:540-344-3276
Practice Address - Fax:540-342-4399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VACI2067Medicare PIN
VAC05866Medicare PIN