Individual
MARILYN BLACKSTON. MD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3655 OLD COURT RD, SUITE 7, BALTIMORE, MD 21208
(443) 431-3208
Mailing address
3409 WILD CHERRY RD., BALTIMORE, MD 21244
(443) 431-3208
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
D0031470
MD
Other
Enumeration date
05/12/2018
Last updated
05/12/2018
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