Individual
DR. MICHAEL BLACKSMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
517 8TH AVE NE, HAZEN, ND 58545-4638
(701) 748-2256
(701) 748-2257
Mailing address
322 7TH AVE NW, HAZEN, ND 58545-4108
(701) 748-3623
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9158
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11992
—
ND
Enumeration date
02/16/2006
Last updated
05/14/2013
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