Organization
BLAIR SURGICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUBHASHIS MAITRA MD (PRESIDENT CORPORATION)
(814) 942-6038
Entity
Organization
Contact information
Practice address
2525 NINTH AVENUE, SUITE 1B, ALTOONA, PA 16602-2014
(814) 942-6038
(814) 942-6038
Mailing address
2525 NINTH AVENUE, SUITE 1B, ALTOONA, PA 16602-2014
(814) 942-6038
(814) 942-6038
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017867790005
—
PA
01
—
CI2845
RAILROAD MEDICARE
—
Enumeration date
04/17/2006
Last updated
02/12/2008
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