Organization
BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.
Active
Organization
BLUE RIDGE HEALTHCARE MEDICAL GROUP, INC.
Active
Other names
Blue Ridge HealthCare Urology
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA MOLL (SVP-CFO)
(828) 580-5003
Entity
Organization
Contact information
Practice address
730 MALCOLM BLVD STE 100, CONNELLY SPRINGS, NC 28612-8079
(828) 580-7962
(828) 580-3392
Mailing address
730 MALCOLM BLVD STE 100, CONNELLY SPRINGS, NC 28612-8079
(828) 580-7962
(828) 580-3392
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1227Y
BCBS
NC
05
—
891227Y
—
NC
Enumeration date
01/08/2010
Last updated
02/13/2025
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