Organization
BLANZY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN E BLANZY D.O. (PRESIDENT)
(734) 285-0677
Entity
Organization
Contact information
Practice address
14319 DIX TOLEDO RD, SOUTHGATE, MI 48195-2506
(734) 285-0677
(734) 285-3574
Mailing address
14319 DIX TOLEDO RD, SOUTHGATE, MI 48195-2506
(734) 285-0677
(734) 285-3574
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101011136
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134169444
NPI INDIVIDUAL NUMBER
MI
01
—
1164462347
INDIVIDUAL NPI #
MI
01
—
1629017207
NPI INDIVIUAL #
MI
01
—
1710926399
INDIVIDUAL NPI #
MI
Enumeration date
11/16/2006
Last updated
02/24/2010
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