| Dr Brian B Blackburn, MD | |
|
146 Medical Park Rd, Ste 106, Mooresville, NC 28117-8528 | |
| (704) 664-5131 | |
| (704) 664-7547 |
| Full Name | Dr Brian B Blackburn |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Location | 146 Medical Park Rd, Mooresville, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568405520 | NPI | - | NPPES |
| 7915979 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 29531 (North Carolina) | Primary |
| Entity Name | Vidant Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477648731 PECOS PAC ID: 0345343893 Enrollment ID: O20070321000445 |
| Entity Name | Hospital Physician Services - Southeast Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760410385 PECOS PAC ID: 5597774554 Enrollment ID: O20100512000495 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Brian B Blackburn, MD 146 Medical Park Rd, Ste 106, Mooresville, NC 28117-8528 Ph: (704) 664-5131 | Dr Brian B Blackburn, MD 146 Medical Park Rd, Ste 106, Mooresville, NC 28117-8528 Ph: (704) 664-5131 |
Aileen Deng, Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 170 Medical Park Rd Ste 101, Mooresville, NC 28117 Phone: 980-302-7070 Fax: 980-302-7075 | |
Laila Noor Menon, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 170 Medical Park Rd, Mooresville, NC 28117 Phone: 704-664-9506 | |
Patrick L. Fry, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 170 Medical Park Rd, Ste 140a, Mooresville, NC 28117 Phone: 704-663-4443 | |
Dr. Suraj Arora, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 134 Medical Park Rd Ste 200, Mooresville, NC 28117 Phone: 704-384-7972 Fax: 704-384-7973 | |
Richard Krumdieck, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 170 Medical Park Road, Ste 101, Mooresville, NC 28117 Phone: 704-799-3946 Fax: 704-799-3956 | |
Dr. Stephen Peter Stowe, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 603 East Center St, Suite A, Mooresville, NC 28115 Phone: 704-663-5090 Fax: 704-663-5502 | |
Dr. Smitha Reddy Pasula, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 930 W Wilson Ave, Mooresville, NC 28117 Phone: 704-663-7500 |