Bertholf, Max Erwin

Bertholf, Max Erwin is an sole proprietor health care provider with primary practice located at 498 Coyner Springs Rd Roanoke Valley Juvenile Detention Center, Med. Director, Roanoke VA 24012-9038. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Bertholf, Max Erwin can be contacted via phone (540) 561-3840.

Contact Information

Primary practice address
498 Coyner Springs Rd Roanoke Valley Juvenile Detention Center, Med. Director Roanoke VA 24012-9038
Phone: (540) 561-3840
Fax: (540) 561-3848
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 0101012335 Virginia

Profile Details

NPI number 1619147691
LBN Legal business name Bertholf, Max Erwin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 6th, 2008
Last updated Mar 6th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619147691 NPPES
Virginia MEDICAID BO7559

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