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Individual

DR. MICHAEL EDWARD BLOCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1900 RANDOLPH RD STE 216, CHARLOTTE, NC 28207-1106
(704) 316-5330
(704) 384-5992
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-5416
(704) 384-5992

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
9600215
NC
207RI0200X
Infectious Disease Physician
Primary
9600215
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010238323
VA
01
1037P
BLUE CROSS/ BLUE SHIELD
NC
01
17461
PARTNER'S MEDICARE
NC
01
199003
WELLPATH
NC
01
200157944
CIGNA
NC
01
2117717
MAMSI
NC
01
301145600
OWCP
NC
01
346879
GREAT WEST
NC
01
5711536
AETNA
NC
01
6579469
CIGNA
NC
05
891037P
NC
01
9022381
UNITED HEALTHCARE
NC
01
C8899
MEDCOST
NC
Enumeration date
04/06/2006
Last updated
08/11/2021
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