Individual
DR. GLENDA JOY LOPEZ-BLAZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8710 N DIXIE DR, DAYTON, OH 45414-2406
(937) 415-0501
(937) 415-0520
Mailing address
8710 N DIXIE DR, DAYTON, OH 45414-2406
(937) 415-0501
(937) 415-0520
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-05-0692-L
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0983002
—
OH
Enumeration date
08/19/2005
Last updated
02/15/2010
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