| Organization Name: | BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC. |
| NPI Number: | 1053546523 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT FRITTS (SVP-CFO) |
| Mailing Address: | 730 Malcolm Blvd. Suite 220 Rutherford College |
| State: | NC US |
| Postal Code: | 28671 |
| Phone Number: | 8288793572 |
| Fax Number: | 8285804229 |
| NPI Enumeration Date: | 05/27/2009 |
| NPI Last Update Date: | 04/21/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0129X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Vascular Surgery |
| Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |