Charlene Lydia Blaine

NPI 1063403160 - Internal Medicine - 207RS0012X

NPI Details
NPI 1063403160
Enumeration Date 10/31/2005
Last Updated 06/16/2008
Entity Type Healthcare Provider
Active Over 12 years ago
Authorized Information
Name CHARLENE LYDIA CHARLENE
Position PRESIDENT
Phone (919) 359-9920
Fax (919) 359-2520
Practice Location
11048 CLEVELAND ROAD
SUITE 101-102
GARNER NC, 27529, US
Phone (919) 359-9920
Fax (919) 359-2520
Business Location
11048 CLEVELAND ROAD
SUITE 101-102
GARNER NC, 27529, US
Phone (919) 359-9920
Fax (919) 359-2520
Toxanomy
Taxonomy Code 207RS0012X
License State North Carolina
License Number 9500533
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According to our database, Charlene Lydia Blaine NPI is 1063403160, taxonomy code is 207RS0012X and license number is 9500533, license state is located at North Carolina. Charlene Lydia Blaine physically located at 11048 Cleveland Road, Garner NC, 27529. NPI Number 1033115704 has the healthcare provider type.

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1063403160 NPI number is provided on an as is basis without warranty of any kind. 1063403160 is maintained by the National Plan & Provider Enumeration System. The contents of Charlene Lydia Blaine are for informational purposes only.