Kathleen K Blazek
Emergency Physician Emergency Medical Services
100 Michigan St Ne
Grand Rapids
, Michigan 49503-2560
Kathleen K Blazek
Emergency Physician Emergency Medical Services
100 Michigan St Ne
Grand Rapids
, Michigan 49503-2560
(616) 285-0846
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About
Features
Specialties
- Emergency Physician
- Emergency Medical Services
Languages spoken
- English
Location
First Address
- Kathleen K Blazek
- Po Box 22067
- Lansing, MI
- Zip : 48909-8016
- Fax : (616) 285-0846
- Phone : (616) 975-1845
Second Address
- Kathleen K Blazek
- 100 Michigan St Ne
- Grand Rapids, MI
- Zip : 49503-2560
- Phone : (616) 391-1680
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207P00000X | Emergency Physician | 4301081742 | MI |
| N | 207PE0004X | Emergency Medical Services | 4301081742 | MI |
National Provider Identifier
| NPI | 1083672729 |
|---|---|
| Provider Name | Kathleen K Blazek |
| First Address | Lansing, MI 48909-8016 |
| Second Address | Grand Rapids, MI 49503-2560 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/05/2006 |
| Last Update Date | 23/07/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| P00398769 | RAILROAD MEDICARE (01) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.