Individual
MARTIN ELI BLAGROVE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-5645
Mailing address
PO BOX 18139, RALEIGH, NC 27619-8139
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
183771
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
250
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430078691
RAILROAD-MEDICARE
NC
05
—
8051673
—
NC
Enumeration date
02/05/2007
Last updated
07/28/2026
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