Blackburn, Andrea Suzette

Blackburn, Andrea Suzette is an individual health care provider with primary practice located at 1003 Woodridge Dr , Lumberton NC 28358-3328. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Blackburn, Andrea Suzette can be contacted via phone (910) 250-5100.

Contact Information

Primary practice address
1003 Woodridge Dr Lumberton NC 28358-3328
Phone: (910) 250-5100
Fax: (910) 250-5111
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2007-01953 North Carolina

Profile Details

NPI number 1235333675
LBN Legal business name Blackburn, Andrea Suzette
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2007
Last updated Apr 7th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235333675 NPPES
North Carolina Other 2022078B MEDICARE
North Carolina MEDICAID 5909793 MEDICARE

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