Individual
THOMAS HAROLD BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 SCUFFLETOWN RD, SIMPSONVILLE, SC 29681-7204
(864) 329-0029
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34991
SC
207P00000X
Emergency Medicine Physician
35587
NC
2085U0001X
Diagnostic Ultrasound Physician
35587
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16021
NCBCBS
NC
05
—
8916021
—
NC
05
—
N35587
—
SC
Enumeration date
07/13/2006
Last updated
03/03/2014
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