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Individual
STACI CHRISTINE BLACKBURN
Active
Individual
STACI CHRISTINE BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301084180
MI
208M00000X
Hospitalist Physician
4301084180
MI
Other
Enumeration date
05/24/2007
Last updated
12/05/2018
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