Individual
MARIE BLAIZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
705 DIXIE ST, CARROLLTON, GA 30117-3818
(770) 838-8824
(770) 838-8563
Mailing address
119 AMBULANCE DR, SUITE 202, CARROLLTON, GA 30117-3857
(770) 838-8824
(770) 838-8563
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
076302
GA
207R00000X
Internal Medicine Physician
MD61514731
WA
208M00000X
Hospitalist Physician
Primary
076302
GA
Other
Enumeration date
05/16/2013
Last updated
01/10/2024
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