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
106TH 4TH STREET, BLADENBORO, NC 28320
(910) 863-3138
(910) 863-3597
Mailing address
PO BOX 370, BLADENBORO, NC 28320
(910) 863-3138
(910) 863-3597
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
200993
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
344601A
—
NC
05
—
344601C
—
NC
Enumeration date
04/03/2007
Last updated
08/07/2008
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