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:
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Mailing Address - Street 1:3010 ANDERSON DR STE 100
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7720
Mailing Address - Country:US
Mailing Address - Phone:919-244-2225
Mailing Address - Fax:919-446-3959
Practice Address - Street 1:3010 ANDERSON DR STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7720
Practice Address - Country:US
Practice Address - Phone:919-244-2225
Practice Address - Fax:919-446-3959
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCP12185225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist