# JUSTIN BLATY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1548766835
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080S0012X | Pediatric Sleep Medicine Physician | 77233 | WI | — |
| 2080S0012X | Pediatric Sleep Medicine Physician | M-17623 | ID | Yes |
| 2080S0012X | Pediatric Sleep Medicine Physician | MD61145727 | WA | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | NULL | — |

## Other

- **Enumeration date:** 04/04/2018
- **Last updated:** 05/19/2024