Individual
JOHN E BLANZY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
14319 DIX-TOLEDO RD, SOUTHGATE, MI 48195
(734) 285-0677
(734) 285-3574
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1863
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101004825
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107352
CARE CHOICES
—
05
—
111182991
—
MI
01
—
5820194
BCBSM
MI
01
—
DR820558
M-CARE
—
Enumeration date
06/06/2006
Last updated
10/22/2020
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