Individual
MATTHEW S BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519-9606
(616) 252-6199
(616) 252-6269
Mailing address
5900 BYRON CENTER AVE SW, MEDICAL ADMINISTRATION, WYOMING, MI 49519-9606
(616) 252-3243
(616) 252-0260
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101013442
MI
207R00000X
Internal Medicine Physician
MB013442
MI
208M00000X
Hospitalist Physician
Primary
5101013442
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4236370
—
MI
Enumeration date
04/20/2006
Last updated
03/22/2018
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