Provider Demographics
NPI:1184804320
Name:BOONE NEUROLOGICAL SERVICES, PA
Entity type:Organization
Organization Name:BOONE NEUROLOGICAL SERVICES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:MCADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-264-7720
Mailing Address - Street 1:895 STATE FARM RD
Mailing Address - Street 2:SUITE 501
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4917
Mailing Address - Country:US
Mailing Address - Phone:828-264-7720
Mailing Address - Fax:828-264-7636
Practice Address - Street 1:895 STATE FARM RD
Practice Address - Street 2:SUITE 501
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4917
Practice Address - Country:US
Practice Address - Phone:828-264-7720
Practice Address - Fax:828-264-7636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC96016972084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC790276Medicaid
NC0276FOtherBCBS
NC2243588AOtherMEDICARE
G58639Medicare UPIN