Individual
MICHAEL WARNER BLACKSTONE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
619 19TH ST S, BIRMINGHAM, AL 35249-1900
(205) 934-5038
Mailing address
2621 KEMP CT, BIRMINGHAM, AL 35226-1982
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/16/2007
Last updated
05/10/2011
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