Individual
MARY M BLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1168 FIRST COLONIAL RD, VIRGINIA BEACH, VA 23454-2444
(757) 686-3508
(757) 686-0541
Mailing address
PO BOX 7068, PORTSMOUTH, VA 23707-0068
(757) 967-8622
(757) 686-0541
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101256886
VA
207Q00000X
Family Medicine Physician
18471
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001737863
MS BCBS
WV
05
—
3810000329
—
WV
05
—
3810000660
—
WV
Enumeration date
12/05/2005
Last updated
11/17/2014
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