Individual
AMY V.H. BLASEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1215 E MICHIGAN AVE, LANSING, MI 48912-1811
(517) 364-2223
Mailing address
PO BOX 634280, CINCINNATI, OH 45263-0041
(517) 336-8080
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
011038
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0153310435
BLUE CROSS BLUE SHIELD
MI
01
—
200000001261
PHP & PHPFC
MI
05
—
3081192
—
MI
Enumeration date
09/22/2006
Last updated
12/06/2007
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