Individual
MARY T BLACKWELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
DOWLING 3 SOUTH ONE BOSTON MEDICAL CENTER PLACE, CHILD HEALTH FOUNDATION OF BOSTON, BOSTON, MA 02118
(617) 414-5170
(617) 414-3803
Mailing address
ONE BOSTON MEDCIAL CENTER PLACE, DIVISION OF PEDIATRICS DOWLING 3 SOUTH, BOSTON, MA 02118
(617) 414-5170
(617) 414-3803
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
78516
MA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
78516
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3114147
—
MA
Enumeration date
11/21/2005
Last updated
09/11/2025
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