Individual
MARK R BLACKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
36 MADBURY RD, DURHAM, NH 03824-2021
(603) 868-5080
(603) 868-7440
Mailing address
789 CENTRAL AVE, DOVER, NH 03820-2526
(603) 868-5080
(603) 868-7440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8732
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376599217
—
ME
05
—
3075907
—
NH
Enumeration date
05/25/2006
Last updated
02/17/2014
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