Individual
DENISE E BLAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
326 N SAWYER RD, KENDALLVILLE, IN 46755-2573
(260) 349-9166
(260) 349-9175
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01052983A
IN
207Q00000X
Family Medicine Physician
35084375
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200187450
—
IN
05
—
2478279
—
OH
Enumeration date
08/09/2005
Last updated
11/03/2025
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