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Individual
STEPHEN REAGOR BLAIR
Active
Individual
STEPHEN REAGOR BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9600
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4005942
AETNA PROVIDER ID
—
01
—
51087303
BLUE CROSS PROVIDER #
AL
01
—
631061517
FEDERAL TAX ID
—
Enumeration date
08/13/2006
Last updated
03/08/2013
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