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General NPI Number Information
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NPI Number | 1134149990
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Entity Type | Organization
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Legal Business Name | BLUE MOUNTAIN UROLOGY, PLLC
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 04/07/2009
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Provider Practice Location Address
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Address Line | 15 BRETTWOOD TRCE
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City | CLYDE
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State | NC
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Zip | 28721-8021
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Country | US
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Telephone | 828-452-9700
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Fax | 828-452-3701
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Provider Business Mailing Address
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Address Line | 15 BRETTWOOD TRCE
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City | CLYDE
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State | NC
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Zip | 28721-8021
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Country | US
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Telephone | 828-452-9700
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Fax | 828-452-3701
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Authorized Official
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Title or Position | MD/OWNER
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Name | RICHARD HENRY STEELE
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Credential | M.D.
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Telephone | 828-452-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 9600227
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 96-00227
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License Number State | NC
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