Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 01037203A | IN |
NPI | 1023051059 |
---|---|
Provider Name | Donna J Blair |
First Address | Bluffton, IN 46714-2529 |
Second Address | Bluffton, IN 46714-2529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 12/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B46709 | (02) |