| Organization Name: | BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC |
| NPI Number: | 1023376829 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT G FRITTS (SVP/CFO) |
| Mailing Address: | 1041 Morganton Blvd Sw Suite 100 Lenoir |
| State: | NC US |
| Postal Code: | 286455605 |
| Phone Number: | 8289913278 |
| Fax Number: | 8285803279 |
| NPI Enumeration Date: | 04/30/2012 |
| NPI Last Update Date: | 09/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RC0000X |
| License Number: | 2011-00879 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Cardiovascular Disease |
| Taxonomy Definition: | An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |