Individual
ANDREW T BLACKBURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
450 N NEW BALLAS RD STE 150N, SAINT LOUIS, MO 63141-6835
(314) 315-9914
(314) 315-9970
Mailing address
12855 N 40 DR STE 375, SAINT LOUIS, MO 63141-8657
(314) 567-6071
(314) 567-3321
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
036156280
IL
208800000X
Urology Physician
Primary
2017014167
MO
Other
Enumeration date
06/22/2012
Last updated
12/01/2021
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