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Organization

CAPE FEAR PEDIATRICS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
THOMAS LEE BLACKSTONE MD (PRESIDENT)
(910) 392-5634
Entity
Organization

Contact information

Practice address
3505 CONVERSE DRIVE, SUITE 200, WILMINGTON, NC 28403-6132
(910) 392-5634
(910) 794-8554
Mailing address
3505 CONVERSE DRIVE, SUITE 200, WILMINGTON, NC 28403-6132
(910) 392-5634
(910) 794-8554

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
10/12/2006
Last updated
08/22/2020
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