Individual
CHARLA M BLACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1500 W BIG BEAVER RD, STE 105, TROY, MI 48084-3526
(248) 637-4050
(248) 637-4025
Mailing address
1056 DEVONSHIRE RD, GROSSE POINTE PARK, MI 48230-1417
(313) 885-1052
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
4301048499
MI
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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