Individual
DR. LAWRENCE R BLATY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
43555 DALCOMA DR, STE 4, CLINTON TWP, MI 48038-6310
(586) 228-2882
(586) 463-7152
Mailing address
43555 DALCOMA DR, STE 4, CLINTON TWP, MI 48038-6310
(586) 228-2882
(586) 463-7152
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301407526
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126951
CARE CHOICES-PREFERRED
MI
05
—
1792650
—
MI
01
—
25009724
RAILROAD MEDICARE
—
01
—
2505006321
BCN
MI
01
—
C6815
M-CARE
MI
01
—
LB407526
BCBSM
MI
Enumeration date
05/31/2005
Last updated
07/02/2025
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