Provider Demographics
NPI:1598783441
Name:BLACKBURN, CHAME CURTIS (MD)
Entity Type:Individual
Prefix:
First Name:CHAME
Middle Name:CURTIS
Last Name:BLACKBURN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7650 S RIVERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84093-6134
Mailing Address - Country:US
Mailing Address - Phone:518-330-1342
Mailing Address - Fax:
Practice Address - Street 1:CORNER OF STEWART AND GARAWAY
Practice Address - Street 2:
Practice Address - City:WHAKATANE
Practice Address - State:BAY OF PLENTY
Practice Address - Zip Code:31200
Practice Address - Country:NZ
Practice Address - Phone:518-330-1342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237019207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02669432Medicaid
NYRA7943Medicare ID - Type Unspecified
NY02669432Medicaid