Individual
WILLIAM BLAKE PEMBERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1010 COLLEGE ST, OXFORD, NC 27565-2507
(919) 690-3000
Mailing address
210 TOWNE VILLAGE DR, CARY, NC 27513-8910
(919) 859-3373
(919) 336-4363
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2015-01934
NC
207P00000X
Emergency Medicine Physician
ME142310
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L2853
FL MEDICARE
FL
Enumeration date
05/02/2013
Last updated
05/05/2020
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