Individual
DR. LAURA L BLAISDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD/MPH
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2911
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2911
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
017899
ME
208000000X
Pediatrics Physician
EC-05-003
ME
Other
Enumeration date
11/21/2006
Last updated
03/17/2020
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