Provider Demographics
NPI:1184694754
Name:BLOBE, GERARD C (MD)
Entity type:Individual
Prefix:DR
First Name:GERARD
Middle Name:C
Last Name:BLOBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MANOR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-2540
Mailing Address - Country:US
Mailing Address - Phone:919-932-4411
Mailing Address - Fax:919-668-2458
Practice Address - Street 1:BOX 2631 DUMC
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-668-1352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3168182Medicaid
NC2281242Medicare PIN
NC3168182Medicaid
NCG49659Medicare UPIN