Individual
KSENIA NIKOLAYEVNA BLINNIKOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
50 STANIFORD ST FL 9, BOSTON, MA 02114-2506
(612) 724-6610
Mailing address
50 STANIFORD ST FL 9, BOSTON, MA 02114-2506
(614) 724-6610
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1013709
MA
207QB0002X
Obesity Medicine (Family Medicine) Physician
1013709
MA
207QB0002X
Obesity Medicine (Family Medicine) Physician
37486
AL
Other
Enumeration date
01/14/2016
Last updated
08/01/2023
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