Individual
KEVIN BLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
166 STONERIDGE DR, COLUMBIA, SC 29210-8239
(803) 461-3000
Mailing address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 551-0570
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
430110966
MI
Other
Enumeration date
06/21/2012
Last updated
11/01/2018
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