Individual
EBONY BLAIZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6013 FARRINGTON RD STE 301, CHAPEL HILL, NC 27517-8173
(984) 974-6669
Mailing address
PEDIATRIC EDUCATION OFFICE CAMPUS BOX 7593, CHAPEL HILL, NC 27599-7593
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
BLAI-NMH93T
NC
Other
Enumeration date
04/26/2024
Last updated
04/26/2024
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