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Individual

DR. BLAINE E SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8601 VETERANS HWY, SUITE 100, MILLERSVILLE, MD 21108-1547
(410) 729-4451
(410) 729-4470
Mailing address
PO BOX 404442, ATLANTA, GA 30384-4442
(804) 756-5130
(804) 672-6899

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D0021406
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
38110057
CAREFIRST BCBS
DC
01
KC46SH42453901
CAREFIRST BCBS
MD
Enumeration date
08/23/2005
Last updated
02/11/2008
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