Organization Name: | D R BLAND MD PA |
NPI Number: | 1003895889 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEIRDRE ROBINSON BLAND (PRESIDENT) |
Mailing Address: | 201 Executive Park Blvd Winston Salem |
State: | NC US |
Postal Code: | 271031503 |
Phone Number: | 3367749000 |
Fax Number: | |
NPI Enumeration Date: | 01/11/2006 |
NPI Last Update Date: | 01/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207VG0400X |
License Number: | 36315 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | Gynecology |
Taxonomy Definition: |