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Individual

DR. JACALYN CECELIA BLACKWELL-WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
5400 OLD COURT RD STE 300B, RANDALLSTOWN, MD 21133-5100
(410) 521-7337
(410) 521-7377
Mailing address
5400 OLD COURT RD STE 300B, RANDALLSTOWN, MD 21133-5100
(410) 521-7337
(410) 521-7377

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
D35187
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1789J
CAREFIRST
MD
05
443261400
MD
Enumeration date
10/04/2006
Last updated
04/04/2019
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