Individual
PAUL BLACKCLOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
40 CELEBRATION DR, ROCHESTER, NY 14620-2664
(585) 275-7546
Mailing address
601 ELMWOOD AVE BOX 278797, ROCHESTER, NY 14642-5631
(585) 275-7546
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
309252
NY
367500000X
Certified Registered Nurse Anesthetist
309252
NY
Other
Enumeration date
03/22/2016
Last updated
07/07/2023
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