Individual
MELANIE JANE BLACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
155 MEMORIAL DR, PINEHURST, NC 28374-8710
(910) 715-2164
Mailing address
155 MEMORIAL DR, PO BOX 3000, PINEHURST, NC 28374-8710
(910) 715-2164
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
2011-00469
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/04/2008
Last updated
07/07/2015
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