Organization
BLADEN MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA L BOWEN (ADMINISTRATIVE ASSISTANT)
(910) 862-5507
Entity
Organization
Contact information
Practice address
16 3RD STREET, DUBLIN, NC 28332
(910) 862-3528
(910) 862-2207
Mailing address
PO BOX 87, DUBLIN, NC 28332-0087
(910) 862-3528
(910) 862-2207
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
29651
NC
363L00000X
Nurse Practitioner
Primary
200746
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225127459
NPI
NC
01
—
1295824910
NPI
—
01
—
29651
LICENSE NUMBER
—
05
—
348935A
—
NC
05
—
8971626
—
NC
Enumeration date
04/03/2007
Last updated
08/07/2008
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