Organization
D R BLAND MD PA
Active
Organization
D R BLAND MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEIRDRE ROBINSON BLAND MD (PRESIDENT)
(336) 774-9000
Entity
Organization
Contact information
Practice address
201 EXECUTIVE PARK BLVD, WINSTON SALEM, NC 27103-1503
(336) 774-9000
Mailing address
201 EXECUTIVE PARK BLVD, WINSTON SALEM, NC 27103-1503
(336) 774-9000
(336) 774-9012
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
36315
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2329864
MEDICARE GROUP #
NC
01
—
36315
NC STATE LICENSE
NC
Enumeration date
01/11/2006
Last updated
01/23/2008
Update your record
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