Individual
EUGENE BLEECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
NC
207RP1001X
Pulmonary Disease Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
129T6
BC/BS
—
01
—
43248
PARTNERS
—
05
—
5886767
—
VA
01
—
7475353
AETNA
—
05
—
89129T6
—
NC
01
—
B0388
MEDCOST
—
05
—
Q0101G
—
SC
Enumeration date
12/01/2005
Last updated
01/07/2008
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