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General NPI Number Information
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NPI Number | 1649463456
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Entity Type | Organization
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Legal Business Name | ALAMANCE CARDIOLOGY, INTERNAL MEDICINE, AND NUCLEAR MEDICINE, P.A.
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 10/07/2009
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Provider Practice Location Address
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Address Line | 1236 HUFFMAN MILL RD MEDICAL ARTS COMPLEX SUITE 1000
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City | BURLINGTON
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State | NC
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Zip | 27215-8700
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Country | US
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Telephone | 336-538-1092
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Fax | 336-538-9696
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Provider Business Mailing Address
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Address Line | PO BOX 209 SUITE 1000
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City | BURLINGTON
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State | NC
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Zip | 27216-0209
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Country | US
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Telephone | 336-538-1092
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Fax | 336-538-9696
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Authorized Official
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Title or Position | BILLING & INSURANCE MANAGER
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Name | LAVONNE J BLALOCK
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Credential |
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Telephone | 336-538-1092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 35857
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License Number State | NC
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