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Organization

GIM BARRY BLACKSTON, MD, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BARRY C BLACKSTON MD (DIRECTOR)
(864) 242-5678
Entity
Organization

Contact information

Practice address
8 MEMORIAL MEDICAL CT STE 4, GREENVILLE, SC 29605-4400
(864) 242-5678
(864) 242-5679
Mailing address
8 MEMORIAL MEDICAL CT STE 4, GREENVILLE, SC 29605-4400
(864) 242-5678
(864) 242-5679

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16698
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1316948185
NPPES
Enumeration date
09/14/2017
Last updated
07/21/2022
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