Organization
LAWRENCE BLASE MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE BLASE MD (OWNER)
(248) 626-6500
Entity
Organization
Contact information
Practice address
30335 W 13 MILE RD STE 100, FARMINGTON HILLS, MI 48334-2262
(248) 626-6500
Mailing address
30335 W 13 MILE RD STE 100, FARMINGTON HILLS, MI 48334-2262
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207VG0400X
Gynecology Physician
—
—
Other
Enumeration date
08/11/2020
Last updated
08/11/2020
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