Provider Demographics
NPI:1013327188
Name:THE CENTER FOR ULTRA HEALTH LLC
Entity type:Organization
Organization Name:THE CENTER FOR ULTRA HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-312-5595
Mailing Address - Street 1:6015 CAVALIER DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-3881
Mailing Address - Country:US
Mailing Address - Phone:540-312-5595
Mailing Address - Fax:
Practice Address - Street 1:4235 COLONIAL AVE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-4002
Practice Address - Country:US
Practice Address - Phone:540-312-5595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231117207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty