Healthcare Provider Details

I. General information

NPI: 1154243707
Provider Name (Legal Business Name): BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 E PARKER RD STE B
MORGANTON NC
28655-5122
US

IV. Provider business mailing address

352 E PARKER RD STE B
MORGANTON NC
28655-5122
US

V. Phone/Fax

Practice location:
  • Phone: 828-580-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA MOLL
Title or Position: SVP/CFO
Credential:
Phone: 828-580-5003