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Organization
BLACKSTONE MEDICAL, PLLC
Active
Organization
BLACKSTONE MEDICAL, PLLC
Active
Other names
Riverstone Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHALID AMRO HARARAH MD (CEO/OWNER)
(801) 688-0210
Entity
Organization
Contact information
Practice address
688 E VINE ST STE 16, MURRAY, UT 84107-5541
(801) 688-0210
Mailing address
688 E VINE ST STE 16, MURRAY, UT 84107-5541
(801) 509-9138
(801) 797-0237
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
—
NULL
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
—
—
Other
Enumeration date
12/25/2023
Last updated
09/04/2025
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