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General NPI Number Information
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NPI Number | 1689837106
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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 | 07/03/2008
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 2203 S. STERLING STREET
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City | MORGANTON
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State | NC
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Zip | 28655-0000
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Country | US
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Telephone | 828-580-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 2203 S. STERLING STREET
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City | MORGANTON
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State | NC
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Zip | 28655-0000
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Country | US
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Telephone | 828-580-4000
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Fax |
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Authorized Official
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Title or Position | SVP-CFO
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Name | ROBERT FRITTS
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Credential |
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Telephone | 828-580-5035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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