Provider Demographics
NPI:1205322039
Name:AMERICAN MED GLOBAL PARTNER INC
Entity type:Organization
Organization Name:AMERICAN MED GLOBAL PARTNER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:TRUTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-440-7379
Mailing Address - Street 1:924 2ND ST SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4408
Mailing Address - Country:US
Mailing Address - Phone:804-980-9801
Mailing Address - Fax:
Practice Address - Street 1:924 2ND ST SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4408
Practice Address - Country:US
Practice Address - Phone:804-980-9801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-04
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management