Individual
MATTHEW DANA BLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
147 OAKLAND LN, MAYNARDVILLE, TN 37807-3354
(865) 806-2182
Mailing address
416 TRIPLE CROWN BLVD, KNOXVILLE, TN 37934-1209
(865) 806-2182
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
52703
TN
208000000X
Pediatrics Physician
Primary
52703
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2012
Last updated
09/29/2021
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