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STEVEN ERIC BLACKWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
620 CHEROKEE ST NE STE 300, MARIETTA, GA 30060-7233
(770) 635-1812
Mailing address
900 CIRCLE 75 PKWY SE STE 1700, ATLANTA, GA 30339-3087
(770) 953-6929
(770) 953-6972

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
4301111523
MI
207X00000X
Orthopaedic Surgery Physician
Primary
89173
GA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
25843
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02887511
MS
01
687245
MEDICARE
MS
Enumeration date
03/26/2012
Last updated
07/26/2021
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