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Organization
P F BLOMGREN & D C KELLER PTR
Active
Organization
P F BLOMGREN & D C KELLER PTR
Active
Other names
Greensboro Family Practice Associates LLP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER F BLOMGREN M.D. (MANAGING PARTNER)
(336) 553-0045
Entity
Organization
Contact information
Practice address
317 W WENDOVER AVE, GREENSBORO, NC 27408-8401
(336) 553-0045
(336) 553-0505
Mailing address
317 W WENDOVER AVE, GREENSBORO, NC 27408-8401
(336) 553-0045
(336) 553-0505
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200001392336
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01667
BCBS
NC
01
—
1311190001
PALMETTO
NC
05
—
89016679
—
NC
Enumeration date
12/20/2006
Last updated
10/06/2010
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