Blackburn, Sara Marie Genutis

Blackburn, Sara Marie Genutis is an individual health care provider with primary practice located at 8600 Nicollet Ave S , Bloomington MN 55420-2824. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Blackburn, Sara Marie Genutis can be contacted via phone (952) 541-2800.

Contact Information

Primary practice address
8600 Nicollet Ave S Bloomington MN 55420-2824
Phone: (952) 541-2800
Fax: (952) 886-7023
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2006015934 Missouri
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 56809 Minnesota

Profile Details

NPI number 1265602478
LBN Legal business name Blackburn, Sara Marie Genutis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 4th, 2008
Last updated Dec 23rd, 2014 - about 11 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 1265602478 NPPES
Iowa MEDICAID 1265602478
Iowa Other 175150022
Iowa MEDICAID 0002495187

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