Provider Demographics
NPI:1578790051
Name:BLEMKER, MICHAEL BERRIEN JR (PT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:BERRIEN
Last Name:BLEMKER
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1370
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-1370
Mailing Address - Country:US
Mailing Address - Phone:919-603-5400
Mailing Address - Fax:919-603-5404
Practice Address - Street 1:110 MAIN ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NC
Practice Address - Zip Code:27565-3319
Practice Address - Country:US
Practice Address - Phone:919-603-5400
Practice Address - Fax:919-603-5404
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP12185225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist