Individual
ELISE R BLASEG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1250 E 3900 S STE 260, SALT LAKE CITY, UT 84124-1371
(801) 265-2000
Mailing address
PO BOX 810, HANOVER, NH 03755-0810
(603) 308-1467
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35012
NH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2022
Last updated
10/15/2025
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