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Individual

DR. CHARLES LEE BLAIR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
836 FARMINGTON AVE STE 217B, WEST HARTFORD, CT 06119-1545
(860) 523-1451
(860) 523-1437
Mailing address
836 FARMINGTON AVE STE 217B, WEST HARTFORD, CT 06119-1545
(860) 523-1451
(860) 523-1437

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
024703
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010024703CT02
ANTHEM ID NUMBER
CT
05
1247030
CT
Enumeration date
02/05/2007
Last updated
02/17/2023
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