Individual
MARK N BLASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1320 MERCY DR NW, CANTON, OH 44708-2614
(330) 489-1044
Mailing address
1320 MERCY DR NW, CANTON, OH 44708-2614
(330) 489-1044
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
34008274
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902827876
GROUP NPI
OH
01
—
2157366
GROUP MEDICAID
OH
05
—
2585715
—
OH
Enumeration date
11/14/2005
Last updated
02/01/2010
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