Marilyn Blackston. MD, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

D0031470 Issued in MD

Practice address

3655 Old Court Rd
Suite 7
Baltimore, MD 21208

Phone

(443) 431-3208

NPI assigned

May 12, 2018

Last updated

May 12, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526083200000",
    "number": "1508356866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 WILD CHERRY RD.",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21244",
            "telephone_number": "443-431-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 OLD COURT RD",
            "address_2": "SUITE 7",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21208",
            "telephone_number": "443-431-3208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKSTON. MD",
        "first_name": "MARILYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-12",
        "last_updated": "2018-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MD",
            "license": "D0031470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Blackmon, LCSW-C
• Blackstar Solutions LLC
• Michelle Blackston, FNP
• William Blackston, LCADC
• Yulanda Blackston, LGPC
• Vernita Blackwell Amos, LCSW-C
• Donna Blackwell-Singleton, LPN
• Angelesa Darcena Blackwell
• Caitlin Blackwell, ED.S
• Donna Blackwell

• General Practice Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• General Practice Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.