Individual
DR. ROBERT J BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9263 MEDICAL PLAZA DR, SUITE B, NORTH CHARLESTON, SC 29406-7109
(843) 414-1224
(843) 414-1226
Mailing address
9263 MEDICAL PLAZA DR, SUITE B, NORTH CHARLESTON, SC 29406-7109
(843) 414-1224
(843) 414-1226
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
057150
GA
208100000X
Physical Medicine & Rehabilitation Physician
29700
SC
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
29700
SC
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
53281
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
297002
—
SC
Enumeration date
07/06/2006
Last updated
01/13/2017
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