Blue Ridge Neurology Associates P.C.
Specialist in Kingsport, TN. Organization (NPI-2).
NPI number1639190846
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1639190846
- Entity type
- Organization (NPI-2)
- Legal business name
- Blue Ridge Neurology Associates P.C.
- Organization subpart
- No
- Enumeration date
- Jul 22, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | MD26480 | TN | Yes |
| 174400000X | Specialist | MD20022 | TN |
Practice location
2012 Brookside DrSte. 8
Kingsport, TN 37660-4645
Phone 423-224-4183 · Fax 423-224-4180
Mailing address
2012 Brookside DrSte. 8
Kingsport, TN 37660-4645
Phone 423-224-4183 · Fax 423-224-4180
Authorized official
Michael S Dew
Doctor
4232244183
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