Individual
HEIDI J BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
211 TEMPLE AVE, COLONIAL HEIGHTS, VA 23834-2827
(804) 526-0107
(804) 526-4466
Mailing address
211 TEMPLE AVE, COLONIAL HEIGHTS, VA 23834-2827
(804) 526-0107
(804) 526-4466
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0110002040
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144472705
—
VA
Enumeration date
10/15/2008
Last updated
04/02/2019
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