Individual
DR. ERIC SCOTT BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1535 GULL RD, MSB 015, KALAMAZOO, MI 49048-1650
(269) 226-6933
(269) 226-6949
Mailing address
1535 GULL RD, MSB 015, KALAMAZOO, MI 49048-1650
(269) 226-6933
(269) 226-6949
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301072041
MI
208D00000X
General Practice Physician
4301072041
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104275172
—
MI
05
—
104277720
—
MI
05
—
4321103-10
—
MI
01
—
700G560080
BCBS GROUP-THREE RIVERS HEALTH
MI
01
—
EB072041
BLUE CROSS BLUE SHIELD
MI
Enumeration date
05/18/2006
Last updated
12/27/2022
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