Individual
DR. SAMUEL CHARLES BLACKMAN
Active
Individual
DR. SAMUEL CHARLES BLACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD433904
PA
2080P0207X
Pediatric Hematology & Oncology Physician
220358
MA
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
MD433904
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11372260
CAQH ID
PA
01
—
20074409
AMERIHEALTH MERCY HEALTH PLAN - GENERAL PEDIATRICS
PA
01
—
20074413
AMERIHEALTH MERCY HEALTH PLAN --ONCOLOGY
PA
01
—
30052688
KEYSTONE MERCY HEALTH PLAN --GENERAL PEDIATRICS
PA
01
—
30052689
KEYSTONE MERCY HEALTH PLAN --ONCOLOGY
PA
05
—
64065881
—
KY
Enumeration date
07/07/2005
Last updated
10/03/2008
Update your record
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