Fountain Square Internal Medicine

NPI #1215090683 in Roanoke, Virginia

Provider Information

NPI Number: 1215090683
Entity Type: Organization
Organization Name: Fountain Square Internal Medicine
Primary Specialty: Internal Medicine
Enumeration Date: Dec 18, 2006
Last Updated: Jan 28, 2010

Practice Location

Address: 1315 2ND ST SW
Address 2: STE 101
City: Roanoke
State: Virginia
ZIP Code: 24016-4935
Phone: (540) 344-5550

Authorized Official

Name: DR. MICHAEL ALAN MALPASS, M.D.
Title: PRESIDENT
Phone: (540) 344-5550

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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