Individual
MARLENE LOUISE BLAISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3400-C OLD MILTON PKWY, SUITE 325, ALPHARETTA, GA 30005-4433
(678) 762-0910
(678) 762-0920
Mailing address
3400-C OLD MILTON PKWY, SUITE 325, ALPHARETTA, GA 30005-4433
(678) 762-0910
(678) 762-0920
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
48028
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000850132B
—
GA
Enumeration date
07/10/2006
Last updated
04/22/2008
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