Healthcare Provider Details

I. General information

NPI: 1972671691
Provider Name (Legal Business Name): BLUE RIDGE PEAKS INTERNAL MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 CANE CREEK RD
FLETCHER NC
28732-9707
US

IV. Provider business mailing address

12 CANE CREEK RD
FLETCHER NC
28732-9707
US

V. Phone/Fax

Practice location:
  • Phone: 828-687-7722
  • Fax: 828-687-7174
Mailing address:
  • Phone: 828-687-7722
  • Fax: 828-687-7174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: ERIC D WEINER
Title or Position: OWNER
Credential: M.D.
Phone: 828-687-7722