# BLADEN MEDICAL ASSOCIATES

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

## Provider details

- **NPI number:** 1457469165
- **Authorized official:** MRS. DONNA L BOWEN (ADMINISTRATIVE ASSISTANT)
- **Authorized official phone:** (910) 862-5500

## Contact information

- **Practice address:** 300 E MCKAY ST, SUITE A, ELIZABETHTOWN, NC 28337-0517
- **Practice address phone:** (910) 862-5500
- **Practice address fax:** (910) 862-2107
- **Mailing address:** PO BOX 517, ELIZABETHTOWN, NC 28337-0517
- **Mailing address phone:** (910) 862-5500
- **Mailing address fax:** (910) 862-2107

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 29651 | NC | Yes |
| 207R00000X | Internal Medicine Physician | 200101455 | NC | — |
| 207R00000X | Internal Medicine Physician | 22998 | NC | — |

## Other

- **Enumeration date:** 08/25/2006
- **Last updated:** 08/18/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 343966A | — | NC |