Provider Demographics
NPI:1295845063
Name:ROANOKE VALLEY PEDIATRICS PLLC
Entity Type:Organization
Organization Name:ROANOKE VALLEY PEDIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BADRIPRASAD
Authorized Official - Middle Name:R
Authorized Official - Last Name:DONTHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-535-5437
Mailing Address - Street 1:915 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-3029
Mailing Address - Country:US
Mailing Address - Phone:252-535-5437
Mailing Address - Fax:252-537-7337
Practice Address - Street 1:915 PARK AVE
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-3029
Practice Address - Country:US
Practice Address - Phone:252-535-5437
Practice Address - Fax:252-537-7337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center