Individual
MICHELE M BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
11970 PRINCE CHARLES CT, CAPE CORAL, FL 33991-7507
(239) 462-8948
Mailing address
11970 PRINCE CHARLES CT, CAPE CORAL, FL 33991-7507
(239) 462-8948
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
OS9069
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16149
BCBS
—
05
—
273116900
—
FL
01
—
OS9069
FLORIDA LICENSE
FL
Enumeration date
05/30/2006
Last updated
01/27/2015
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