Blackwell, Mary T

Blackwell, Mary T is an individual health care provider with primary practice located at Dowling 3 South One Boston Medical Center Place Child Health Foundation Of Boston, Boston MA 02118. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Blackwell, Mary T can be contacted via phone (617) 414-5170.

Contact Information

Primary practice address
Dowling 3 South One Boston Medical Center Place Child Health Foundation Of Boston Boston MA 02118
Phone: (617) 414-5170
Fax: (617) 414-3803
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 78516 Massachusetts
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 78516 Massachusetts

Profile Details

NPI number 1538141965
LBN Legal business name Blackwell, Mary T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538141965 NPPES
Massachusetts MEDICAID 3114147

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