Individual
THOMAS L BLACKSTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3505 CONVERSE DR, STE 200, WILMINGTON, NC 28403-6132
(910) 392-5634
(910) 392-5654
Mailing address
PO BOX 647, HOPE MILLS, NC 28348-0647
(910) 483-7337
(910) 483-0648
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
17469
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12337276
MULTIPLAN
NC
01
—
1409483
UNITED HEALTHCARE
NC
01
—
1542826
WELLPATH
NC
01
—
15986
BCBS OF NC
NC
01
—
1791139
CIGNA GREATWEST
NC
01
—
1912094301
DOCTORS DIRECT
NC
05
—
1912094301
—
NC
01
—
296275
MEDCOST
NC
01
—
4359214
AETNA
NC
01
—
4550753
COVENTRY NATIONAL - COVENTRY PPO
NC
05
—
8915986
—
NC
01
—
FH1101875
FIRST CAROLINA CARE
NC
Enumeration date
10/06/2006
Last updated
06/02/2016
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