| Organization Name: | BLUE RIDGE HEALTHCARE MEDICAL GROUP |
| NPI Number: | 1619119468 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT FRITTS (SVP/CFO) |
| Mailing Address: | 720 Malcolm Blvd Rutherford College |
| State: | NC US |
| Postal Code: | 28671 |
| Phone Number: | 8288797611 |
| Fax Number: | 8288797612 |
| NPI Enumeration Date: | 03/25/2009 |
| NPI Last Update Date: | 04/23/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |