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Individual

GLEN S BLAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
230 WORCESTER ST, WELLESLEY, MA 02481-5420
(781) 431-5255
(781) 431-5329
Mailing address
637 WASHINGTON ST, DORCHESTER, MA 02124-3510
(617) 825-9660
(617) 288-7898

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN157507
MA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN157507
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110018170A
MA
01
C318
HARVARD PILGRIM
MA
01
NP2733
BLUE CROSS
MA
Enumeration date
03/17/2006
Last updated
11/28/2023
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