Organization
PEAK NURITION AND WEIGHT LOSS CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL D. BLACKWELL M.D. (OWNER)
(919) 367-9355
Entity
Organization
Contact information
Practice address
1011 PEMBERTON HILL RD, SUITE 101, APEX, NC 27502-4266
(919) 367-9355
(919) 367-9276
Mailing address
1011 PEMBERTON HILL RD, SUITE 101, APEX, NC 27502-4266
(919) 367-9355
(919) 367-9276
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
L001396
NC
207Q00000X
Family Medicine Physician
32989
NC
Other
Enumeration date
05/23/2007
Last updated
09/11/2025
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