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Individual

DR. MARK A BLAIR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3811 E BELL RD STE 309, PHOENIX, AZ 85032-2160
(602) 971-0950
(602) 992-4971
Mailing address
PO BOX 650886, DEPT. 41958, DALLAS, TX 75265
(805) 919-0094
(480) 222-0269

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
32353
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
32353
ARIZONA LICENSE
AZ
01
P00191312
RAIL ROAD MEDICARE
AZ
Enumeration date
05/26/2006
Last updated
05/14/2025
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