Provider Demographics
NPI:1104098177
Name:PURSEL, BRANDI BLUMLING (DO)
Entity type:Individual
Prefix:DR
First Name:BRANDI
Middle Name:BLUMLING
Last Name:PURSEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 KILDAIRE FARM RD
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-4523
Mailing Address - Country:US
Mailing Address - Phone:919-481-0277
Mailing Address - Fax:
Practice Address - Street 1:1110 KILDAIRE FARM RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4523
Practice Address - Country:US
Practice Address - Phone:919-481-0277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-29
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.009201207Q00000X
NC2008-01705207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5910687Medicaid
NC2401675Medicare PIN