Male or Other

Gerald W. Blackburn DO

Infectious Disease Physician in Farmington Hills, MI(View on Map)

Full Name

Gerald W Blackburn DO

NPI Number

1477597326

NPI Type

Individual Provider

Gender

Male

Enumeration Date

06/15/2006

Specialties

(Taxonomies)

Code

207RI0200X

Primary Taxonomy

Yes

Licenses

State

Michigan

License Number

5101006566

Contact
Information

Purpose

Mailing
Location

Address

26901 BEAUMONT BLVD STE 3D
28080 GRAND RIVER AVE STE 306

City

Southfield
Farmington Hills

State

MI
MI

Postal Code

48033-3849
48336-5966

Country

US
US

Telephone Number

N/A
(947) 521-8314

Health Information Exchange

Endpoint Type

DIRECT

Endpoint

gblackburn96482@direct.beaumont.edu

Endpoint Description

Unknown

Use

Unknown

Content Type

Unknown

Affiliation

N

Endpoint Location

28080 Grand River Ave Ste 306Farmington Hills, MI483365966US

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 11/17/2020

Provider Address

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