Organization
COASTAL PEDIATRIC ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS BLACKSTONE M.D. (MANAGING MEMBER)
(910) 202-8020
Entity
Organization
Contact information
Practice address
3505 CONVERSE DR, SUITE 200, WILMINGTON, NC 28403-6131
(910) 392-5634
(910) 777-2022
Mailing address
3505 CONVERSE DR, SUITE 200, WILMINGTON, NC 28403-6131
(910) 392-5634
(910) 777-2022
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
17469
NC
Other
Enumeration date
05/12/2015
Last updated
05/12/2015
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