Blue Heron Medical Group Llc
LBN: Blue Heron Medical Group Llc
Blue Heron Medical Group Llc is an health care organization with primary practice located at 305 10Th St Ste 101, Pocomoke City MD 21851-1607. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty.
Blue Heron Medical Group Llc can be contacted via phone (410) 957-3005, or through Fleury, Paul Reardon via phone (410) 957-3005.
Contact Information
Primary practice address
305 10Th St Ste 101
Pocomoke City MD 21851-1607
Phone: (410) 957-3005
Fax: (410) 957-0550
Website:
Authorized official contact:
Name: Fleury, Paul Reardon Doctor of Medicine (MD)
Phone: (410) 957-3005
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | D058928 | Maryland |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | D45995 | Maryland |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | D24872 | Maryland |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | D24871 | Maryland |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | D36576 | Maryland |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | Q37875 | Maryland |
Profile Details
| NPI number | 1861686313 |
|---|---|
| LBN Legal business name | Blue Heron Medical Group Llc |
| DBA Doing business as | |
| Authorized official | Fleury, Paul Reardon Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 28th, 2007 |
| Last updated | Mar 1st, 2012 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861686313 | NPPES |
| Maryland | Other | 1841384625 | NPI |
| Maryland | Other | 1245292853 | NPI |
| Maryland | Other | 1639269368 | NPI |
| Maryland | Other | 1265491286 | NPI |
| Maryland | Other | 1669558227 | NPI |
| Maryland | Other | 1992764815 | NPI |
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