Provider Demographics
NPI:1013478965
Name:INMAN, DENISE MARIE (DO)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:MARIE
Last Name:INMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:MARIE
Other - Last Name:PAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21 HIGHLAND AVE SE STE 200
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24013-2218
Mailing Address - Country:US
Mailing Address - Phone:814-421-9211
Mailing Address - Fax:
Practice Address - Street 1:21 HIGHLAND AVE SE STE 200
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24013-2218
Practice Address - Country:US
Practice Address - Phone:540-982-8881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT019496207V00000X
390200000X
VA0102208188207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program