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Organization
BLAIR MEDICAL ASSOCIATES
Active
Organization
BLAIR MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BRYAN (PROJECTS MGR.)
81494976211
Entity
Organization
Contact information
Practice address
1414 9TH AVE, ALTOONA, PA 16602-2454
(814) 949-7621
(814) 949-7616
Mailing address
1414 9TH AVE, STATION MEDICAL CENTER, ALTOONA, PA 16602-2415
(814) 949-7621
(814) 949-7616
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC002353L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0719120001
DMERC PROVIDER NUMBER
PA
01
—
1007393100001
PODIATRY MED. ASST. #
PA
01
—
1015429
PODIATRY GHP #
PA
01
—
117185
HIGHMARK
PA
Enumeration date
06/27/2006
Last updated
05/27/2008
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