Individual
DR. DANIEL R. BLIZZARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
120 CAUSEWAY DR STE 3, OCEAN ISLE BEACH, NC 28469-7581
(910) 575-5004
(855) 575-0700
Mailing address
120 CAUSEWAY DR STE 3, OCEAN ISLE BEACH, NC 28469-7581
(910) 575-5004
(855) 575-0700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2007-01189
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036114617
—
IL
01
—
147N6
BCBS OF NC
NC
01
—
200701189
MEDICAL LICENSE
NC
05
—
5908511
—
NC
Enumeration date
06/17/2006
Last updated
03/17/2018
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