Individual
DOUGLAS A BLACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1002 N CHURCH ST, STE 302, GREENSBORO, NC 27401-1449
(336) 387-8100
(336) 387-8202
Mailing address
1002 N CHURCH ST, GREENSBORO, NC 27401-1439
(336) 387-8100
(336) 387-8202
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
99-00427
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126PN
BLUE CROSS BLUE SHIELD OF
NC
01
—
185173
MEDCOST
NC
05
—
89126PN
—
NC
Enumeration date
10/12/2006
Last updated
10/27/2016
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