Provider Demographics
NPI:1255438461
Name:VALLEY INTERNAL MEDICINE ASSOCIATES P.C.
Entity type:Organization
Organization Name:VALLEY INTERNAL MEDICINE ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-380-3722
Mailing Address - Street 1:3737 W. MAIN STREET
Mailing Address - Street 2:STE 102
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-2073
Mailing Address - Country:US
Mailing Address - Phone:540-380-3722
Mailing Address - Fax:833-378-0873
Practice Address - Street 1:3737 W. MAIN STREET
Practice Address - Street 2:STE 102
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-2073
Practice Address - Country:US
Practice Address - Phone:540-380-3722
Practice Address - Fax:833-378-0873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CH8125OtherMEDICARE RAILROAD
C06916Medicare PIN