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Individual
ROBERT EUGENE BLACKBURN
Active
Individual
ROBERT EUGENE BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
169882
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000912964001
HEALTHNOW
NY
05
—
01039918
—
NY
01
—
5520487
AETNA
NY
01
—
6948
BLUE CROSS BLUE SHIELD
NY
01
—
CFP1698828
WORKERS COMPENSATION
NY
01
—
MD130D
PREFERRED CARE
NY
Enumeration date
04/27/2006
Last updated
11/13/2007
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