Individual
CAROL BLAISDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
160 E ERIE AVE, PHILADELPHIA, PA 19134-1011
(215) 427-5085
Mailing address
PO BOX 62063, BALTIMORE, MD 21264-2063
(410) 706-5181
(410) 706-5103
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
D4210
MD
2080P0214X
Pediatric Pulmonology Physician
Primary
MD482909
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
302691400
—
MD
Enumeration date
05/23/2006
Last updated
11/06/2023
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