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General NPI Number Information
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NPI Number | 1578618591
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Entity Type | Organization
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Legal Business Name | BLUE RIDGE PAIN MANAGEMENT & PALLIATIVE CARE PA
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 06/29/2021
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Provider Practice Location Address
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Address Line | 3 WALDEN RIDGE DR STE 100
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City | ASHEVILLE
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State | NC
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Zip | 28803-8587
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Country | US
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Telephone | 828-350-9310
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Fax | 828-350-9311
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Provider Business Mailing Address
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Address Line | 3 WALDEN RIDGE DR STE 100
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City | ASHEVILLE
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State | NC
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Zip | 28803-8587
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Country | US
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Telephone | 828-350-9310
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Fax | 828-350-9311
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES BUZZANELL
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Credential | M.D.
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Telephone | 828-350-9310
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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 | 0098-00481
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License Number State | NC
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