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Individual
JAMES ELDRIDGE BLAINE JR.
Active
Individual
JAMES ELDRIDGE BLAINE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36003408
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2553062
—
OH
01
—
9354431
MEDICARE GROUP #
OH
Enumeration date
09/11/2006
Last updated
07/10/2014
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