Blanks, Deidra

Blanks, Deidra is an individual health care provider with primary practice located at 1839 Quiet Cv , Fayetteville NC 28304-3857. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery, Allopathic & Osteopathic Physicians / Otology & Neurotology. Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery is her primary health care specialty. Blanks, Deidra can be contacted via phone (910) 323-1463.

Contact Information

Primary practice address
1839 Quiet Cv Fayetteville NC 28304-3857
Phone: (910) 323-1463
Fax: (910) 323-1575
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery 207YX0905X 2006-00621 North Carolina
Allopathic & Osteopathic Physicians / Otology & Neurotology 207YX0901X 2006-00621 North Carolina
Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery 207YX0905X 2011003947 Missouri

Profile Details

NPI number 1619170529
LBN Legal business name Blanks, Deidra
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2007
Last updated Jun 11th, 2021 - about 4 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 1619170529 NPPES
North Carolina MEDICAID 1619170529

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