| Peter F Blomgren MD PLLC | |
|
317 W Wendover Ave Greensboro NC 27408-8401 | |
| (336) 553-0045 | |
| Not Available |
| Full Name | Peter F Blomgren MD PLLC |
|---|---|
| Speciality | Family Medicine |
| Location | 317 W Wendover Ave, Greensboro, North Carolina |
| Authorized Official Name and Position | Peter F Blomgren (OWNER) |
| Authorized Official Contact | 3365530045 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter F Blomgren MD PLLC 317 W Wendover Ave Greensboro NC 27408-8401 Ph: (336) 553-0045 | Peter F Blomgren MD PLLC 317 W Wendover Ave Greensboro NC 27408-8401 Ph: (336) 553-0045 |
| NPI Number | 1043651664 |
|---|---|
| Provider Enumeration Date | 07/11/2013 |
| Last Update Date | 07/11/2013 |
| Medicare PECOS PAC ID | 4183851348 |
|---|---|
| Medicare Enrollment ID | O20131213000212 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043651664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 21535 (North Carolina) | Primary |
| Provider Name | Peter F Blomgren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962565085 PECOS PAC ID: 5698967701 Enrollment ID: I20101007001056 |
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