Provider Demographics
NPI:1770736431
Name:ALLERGY & ASTHMA CENTER OF BLUEFIELD, PC
Entity type:Organization
Organization Name:ALLERGY & ASTHMA CENTER OF BLUEFIELD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:W
Authorized Official - Last Name:ASBURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-322-2278
Mailing Address - Street 1:1240 HOCKMAN PIKE
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24605
Mailing Address - Country:US
Mailing Address - Phone:276-322-2278
Mailing Address - Fax:276-322-3650
Practice Address - Street 1:1240 HOCKMAN PIKE
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:VA
Practice Address - Zip Code:24605-9351
Practice Address - Country:US
Practice Address - Phone:276-322-2278
Practice Address - Fax:276-322-3650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5855331Medicaid
WV0070397000Medicaid
VA251572OtherBLUE CROSS/BLUE SHIELD
VA251572OtherBLUE CROSS/BLUE SHIELD