| Blueridge Clinic Pllc | |
|
818 N Eisenhower Dr Ste B Beckley WV 25801-3112 | |
| (681) 238-3115 | |
| (681) 238-6159 |
| Full Name | Blueridge Clinic Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 818 N Eisenhower Dr Ste B, Beckley, West Virginia |
| Authorized Official Name and Position | Angela Dolganiuc (PROVIDER/OWNER) |
| Authorized Official Contact | 6812383115 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blueridge Clinic Pllc Po Box 1882 Beckley WV 25802-1882 Ph: (681) 207-5089 | Blueridge Clinic Pllc 818 N Eisenhower Dr Ste B Beckley WV 25801-3112 Ph: (681) 238-3115 |
| NPI Number | 1922763051 |
|---|---|
| Provider Enumeration Date | 11/03/2021 |
| Last Update Date | 11/03/2021 |
| Medicare PECOS PAC ID | 1557752300 |
|---|---|
| Medicare Enrollment ID | O20220105000965 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922763051 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Angela Dolganiuc |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316232317 PECOS PAC ID: 3476794728 Enrollment ID: I20171115000920 |
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