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General NPI Number Information
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NPI Number | 1477664001
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Entity Type | Organization
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Legal Business Name | BLAND CLINIC, PA
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/12/2013
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Provider Practice Location Address
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Address Line | 1317 N ELM ST SUITE 7
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City | GREENSBORO
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State | NC
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Zip | 27401-1033
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Country | US
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Telephone | 336-373-1557
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Fax | 336-373-1742
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Provider Business Mailing Address
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Address Line | PO BOX 29364
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City | GREENSBORO
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State | NC
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Zip | 27429-9364
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Country | US
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Telephone | 336-373-1557
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Fax | 336-373-1742
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Authorized Official
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Title or Position | PHYSICIAN AND CEO
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Name | DR. VEITA JOYCE BLAND
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Credential | MD
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Telephone | 336-373-1557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 26492
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License Number State | NC
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