Provider Demographics
NPI:1386678597
Name:VALEA, FIDEL ARTHUR (MD)
Entity Type:Individual
Prefix:
First Name:FIDEL
Middle Name:ARTHUR
Last Name:VALEA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RIVERSIDE CIR STE 300M
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4962
Mailing Address - Country:US
Mailing Address - Phone:540-581-0160
Mailing Address - Fax:540-345-8487
Practice Address - Street 1:1 RIVERSIDE CIR STE 300M
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4962
Practice Address - Country:US
Practice Address - Phone:540-581-0160
Practice Address - Fax:540-345-8487
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31668207VX0201X
VA0101261176207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2031792Medicare ID - Type Unspecified