Individual
SUSAN P. BLACKFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4220 N ROXBORO ST, DURHAM, NC 27704-1826
(919) 620-4467
Mailing address
4220 N ROXBORO ST, DURHAM MEDICAL CENTER, DURHAM, NC 27704-1826
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200200005
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89130PY
—
NC
Enumeration date
01/09/2007
Last updated
02/09/2009
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