Blackstone, Marcus E

Blackstone, Marcus E is an sole proprietor health care provider with primary practice located at 404 Se Main St , Simpsonville SC 29681-2652. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Blackstone, Marcus E can be contacted via phone (864) 963-8002.

Contact Information

Primary practice address
404 Se Main St Simpsonville SC 29681-2652
Fax: (864) 963-2742
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 18747 South Carolina

Profile Details

NPI number 1366453458
LBN Legal business name Blackstone, Marcus E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 11th, 2006
Last updated Jun 19th, 2012 - about 12 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 1366453458 NPPES
South Carolina Other P00446146 RR MEDICARE
South Carolina MEDICAID 187470 RR MEDICARE
South Carolina Other 18747 RR MEDICARE
South Carolina Other 576007863095 RR MEDICARE

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