Bladergroen, Mark R

Bladergroen, Mark R is an individual health care provider with primary practice located at 5875 Bremo Rd Suite G-5, Richmond VA 23226-1934. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Bladergroen, Mark R can be contacted via phone (804) 287-7840.

Contact Information

Primary practice address
5875 Bremo Rd Suite G-5 Richmond VA 23226-1934
Phone: (804) 287-7840
Fax: (804) 287-7845
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 0101042193 Virginia

Profile Details

NPI number 1124058342
LBN Legal business name Bladergroen, Mark R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 4th, 2006
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124058342 NPPES
Virginia Other C06778 GROUP PTAN
Virginia MEDICAID 7300221 GROUP PTAN
Virginia Other 0101042193 GROUP PTAN

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