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Individual
ANN E BLACKMAN
Active
Individual
ANN E BLACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2010007130
MO
207Q00000X
Family Medicine Physician
34727
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1242164
—
IA
01
—
135570022
MEDICARE PTAN
MO
05
—
1588640510
—
MO
01
—
P00837677
RAILROAD MEDICARE
MO
01
—
PO00168051
RR MEDICARE
IA
Enumeration date
12/21/2005
Last updated
01/13/2021
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