Mark R Bladergroen
Cardiothoracic Vascular Surgeon
5875 Bremo Rd Suite G-5
Richmond
, Virginia 23226-1934
Mark R Bladergroen
Cardiothoracic Vascular Surgeon
5875 Bremo Rd Suite G-5
Richmond
, Virginia 23226-1934
(804) 287-7845
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About
Features
Specialties
- Cardiothoracic Vascular Surgeon
Languages spoken
- English
Location
First Address
- Mark R Bladergroen
- 5875 Bremo Rd Suite G-5
- Richmond, VA
- Zip : 23226-1934
- Fax : (804) 287-7845
- Phone : (804) 287-7840
Second Address
- Mark R Bladergroen
- 5875 Bremo Rd Suite G-5
- Richmond, VA
- Zip : 23226-1934
- Fax : (804) 287-7845
- Phone : (804) 287-7840
Reviews
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Is Mark R Bladergroen a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208G00000X | Cardiothoracic Vascular Surgeon | 0101042193 | VA |
National Provider Identifier
| NPI | 1124058342 |
|---|---|
| Provider Name | Mark R Bladergroen |
| First Address | Richmond, VA 23226-1934 |
| Second Address | Richmond, VA 23226-1934 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/07/2006 |
| Last Update Date | 30/08/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0101042193 | MEDICAL LICENSE (01) | VA |
| 7300221 | (05) | VA |
| B60024 | (02) | |
| BB1434086 | DEA (01) | |
| C06778 | GROUP PTAN (01) | VA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.