Elizabeth Ivey Blair, MD PHD | |
417 N Main St, Kenansville, NC 28349-8801 | |
(910) 275-0060 | |
(910) 275-0162 |
Full Name | Elizabeth Ivey Blair |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 417 N Main St, Kenansville, 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 |
---|---|---|---|
1740207398 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 39546 (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 |
Mailing Address | Practice Location Address |
---|---|
Elizabeth Ivey Blair, MD PHD Po Box 278, Kenansville, NC 28349-0278 Ph: (910) 275-0060 | Elizabeth Ivey Blair, MD PHD 417 N Main St, Kenansville, NC 28349-8801 Ph: (910) 275-0060 |
Dieter Tetatah Wefuan, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 401 N Main St, Kenansville, NC 28349 Phone: 252-214-8598 | |
Dr. Charles T Marston Jr., MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 401 North Main Street, Kenansville, NC 28349 Phone: 336-963-9066 | |
Dr. Elizabeth Jane Griffin, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 340 Seminary St, Kenansville, NC 28349 Phone: 910-296-2130 Fax: 910-296-2139 |