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General NPI Number Information
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NPI Number | 1548497209
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Entity Type | Organization
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Legal Business Name | BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 06/19/2009
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 2293 SUGAR HILL RD STE C
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City | MARION
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State | NC
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Zip | 28752-7787
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Country | US
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Telephone | 828-580-4661
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Fax |
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Provider Business Mailing Address
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Address Line | 2209 S STERLING ST SUITE 400
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City | MORGANTON
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State | NC
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Zip | 28655-4091
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Country | US
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Telephone | 828-580-4661
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Fax | 828-580-4698
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Authorized Official
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Title or Position | SVP-CFO
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Name | PATRICIA MOLL
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Credential |
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Telephone | 828-580-5003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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