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
88 EAST GREENE STREET, CLARKTON, NC 28433
(910) 647-0083
(910) 647-0126
Mailing address
PO BOX 95, ELIZABETHTOWN, NC 28337-0095
(910) 647-0083
(910) 647-0126
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
101606
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
348934A
—
NC
05
—
348934C
—
NC
Enumeration date
04/03/2007
Last updated
08/22/2020
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