Individual
DR. BRIAN B BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
146 MEDICAL PARK RD, STE 106, MOORESVILLE, NC 28117-8528
(704) 664-5131
(704) 664-7547
Mailing address
146 MEDICAL PARK RD, STE 106, MOORESVILLE, NC 28117-8528
(704) 664-5131
(704) 664-7547
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29531
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7915979
—
NC
Enumeration date
06/14/2006
Last updated
05/24/2016
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