Individual
GERALD W BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
28080 GRAND RIVER AVE STE 306, FARMINGTON HILLS, MI 48336-5966
(947) 521-8314
(248) 478-8864
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
5101006566
MI
Other
Enumeration date
06/15/2006
Last updated
11/17/2020
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