Organization
BURLINGTON MEDICAL PRACTICE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL EDWARD BLOCKER MD (PRESIDENT)
(336) 584-5200
Entity
Organization
Contact information
Practice address
1248 HUFFMAN MILL RD, SUITE 103, BURLINGTON, NC 27215-8700
(336) 584-5200
(336) 584-0099
Mailing address
1183 UNIVERSITY DR, SUITE 105-410, BURLINGTON, NC 27215-8303
(336) 584-5200
(336) 584-0099
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
200600619
NC
174400000X
Specialist
Primary
9600215
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018KU
BCBS
NC
01
—
199001
WELLPATH
NC
01
—
346879
GREAT WEST
NC
01
—
6579469
CIGNA
NC
01
—
7761536
AETNA
NC
05
—
891037P
—
NC
01
—
C8899
MEDCOST
NC
01
—
XXXXXX944
UHC---MEDICARE COMPLETE
NC
Enumeration date
12/04/2006
Last updated
04/19/2011
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