Individual
MR. BLAINE R WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
125 W WALNUT ST, KALAMAZOO, MI 49007-5239
(269) 343-1381
(269) 343-6321
Mailing address
601 JOHN ST, BOX 42, KALAMAZOO, MI 49007-5341
(269) 341-8419
(269) 341-8743
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704101145
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4308752210
BCBS IND PIN
MI
01
—
430C910670
BCBS GRP PIN
MI
01
—
5453510
AETNA PIN
—
Enumeration date
06/15/2006
Last updated
04/09/2013
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