# BLUE RIDGE ANESTHESIA ASSOCIATES

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437194115
- **Authorized official:** MALCOLM ROGERS (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (803) 855-7200

## Contact information

- **Practice address:** 110B BRADLEY AVE, EASLEY, SC 29640-3033
- **Practice address phone:** (803) 855-7200
- **Mailing address:** 255 W MICHIGAN AVE, JACKSON, MI 49201-2218
- **Mailing address phone:** (517) 787-6440
- **Mailing address fax:** (517) 787-4146

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/18/2006
- **Last updated:** 10/23/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP1435 | — | SC |