Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 2016-00286 | NC |
NPI | 1033554811 |
---|---|
Provider Name | Ben Adam Blomberg |
First Address | Chapel Hill, NC 27517-8168 |
Second Address | Chapel Hill, NC 27517-8168 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2013 |
Last Update Date | 31/03/2021 |