Individual
DR. MATTHEW C. BLAZEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
29257 CENTER RIDGE RD, WESTLAKE, OH 44145-5224
(440) 899-7677
(440) 899-7667
Mailing address
PO BOX 378, SANDUSKY, OH 44871-0378
(419) 609-1112
(419) 609-1123
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
48402
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0512850
—
OH
Enumeration date
06/22/2005
Last updated
09/18/2018
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