Organization
BLUE RIDGE FAMILY PRACTICE ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD R TEATER MD (PRES CORP)
(828) 627-3411
Entity
Organization
Contact information
Practice address
243 JONES COVE RD, CLYDE, NC 28721-9483
(828) 627-3411
(828) 627-6607
Mailing address
243 JONES COVE RD, CLYDE, NC 28721-9483
(828) 627-3411
(828) 627-6607
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890137L
—
NC
Enumeration date
12/19/2005
Last updated
08/22/2020
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