Individual
DR. GERARD BLACKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1504 DORCHESTER AVE # B, DORCHESTER, MA 02122-1327
(617) 436-5454
(617) 436-5667
Mailing address
1504 DORCHESTER AVE # B, DORCHESTER, MA 02122-1327
(617) 436-5454
(617) 436-5667
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1561
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1613383
—
MA
01
—
AA25980
HARVARD PILGRIM PROVIDER#
MA
01
—
Y39215
BCBS OF MA PROVIDER NUMBE
MA
Enumeration date
11/13/2006
Last updated
07/09/2007
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