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Individual

DR. STUART L BLACKWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
104 UNION AVE STE 1005, SYRACUSE, NY 13203
(315) 424-0790
(315) 475-0916
Mailing address
PO BOX 419519, BOSTON, MA 02241-9519
(610) 644-8900
(484) 924-0053

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
294864
NY
2086S0129X
Vascular Surgery Physician
Primary
294864
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
042312909
BRIGHAM AND WOMEN'S HOSPITAL
MA
05
05221650
NY
Enumeration date
04/06/2009
Last updated
05/20/2020
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