Blaine, Charlene Lydia

Blaine, Charlene Lydia is an individual health care provider with primary practice located at 343 Technology Dr Suite 1110, Garner NC 27529-7949. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pulmonary Diagnostics, which is considered as her primary health care specialty. Blaine, Charlene Lydia can be contacted via phone (919) 780-5900.

Contact Information

Primary practice address
343 Technology Dr Suite 1110 Garner NC 27529-7949
Phone: (919) 780-5900
Fax: (919) 780-5905
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pulmonary Diagnostics 2278P1004X A-4125 North Carolina

Profile Details

NPI number 1720050578
LBN Legal business name Blaine, Charlene Lydia
Credentials CRT, RCP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2006
Last updated May 10th, 2011 - about 14 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 1720050578 NPPES
North Carolina Other 139EE BLUE SHIELD NC
North Carolina MEDICAID 7492701 BLUE SHIELD NC
North Carolina Other A-4125 BLUE SHIELD NC

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