Individual
BENJAMIN MARTIN BLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 EAST MEDICAL CENTER DRIVE, 1ST FLOOR UNIVERSITY HOSPITAL ROOM 1B300, ANN ARBOR, MI 48109-5036
(734) 936-9035
(734) 936-5520
Mailing address
3621 SOUTH STATE STREET, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301094347
MI
390200000X
Student in an Organized Health Care Education/Training Program
4301094347
MI
Other
Enumeration date
06/30/2009
Last updated
10/08/2013
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