# BLACKSTONE MEDICAL, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Riverstone Medical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902675556
- **Authorized official:** DR. KHALID AMRO HARARAH MD (CEO/OWNER)
- **Authorized official phone:** (801) 688-0210

## Contact information

- **Practice address:** 688 E VINE ST STE 16, MURRAY, UT 84107-5541
- **Practice address phone:** (801) 688-0210
- **Mailing address:** 688 E VINE ST STE 16, MURRAY, UT 84107-5541
- **Mailing address phone:** (801) 509-9138
- **Mailing address fax:** (801) 797-0237

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 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