Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 54061 | KY |
Y | 2080P0208X | Pediatric Infectious Diseases | 54061 | KY |
NPI | 1659799195 |
---|---|
Provider Name | Dr. Daniel B Blatt |
First Address | Chicago, IL 60677-6879 |
Second Address | Louisville, KY 40202-1713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 12/10/2020 |