Individual
DR. ROBERT EARL BLACKWELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
260 HOSPITAL DR STE 201, UKIAH, CA 95482-4533
(707) 463-8000
(707) 462-1111
Mailing address
PO BOX 2739, UKIAH, CA 95482-2739
(707) 463-8000
(707) 462-1111
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
AB7832454
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB11989F
—
CA
05
—
ZZZ74887Z
—
CA
Enumeration date
09/12/2005
Last updated
09/15/2010
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