Individual
BLAIR MACPHAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1855 S MAIN ST, STE A, GOSHEN, IN 46526-4852
(574) 533-7476
Mailing address
1855 S MAIN ST, STE A, GOSHEN, IN 46526-4852
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01039182A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100101820
—
IN
01
—
P01678724
RR PTAN
IN
Enumeration date
05/03/2006
Last updated
05/03/2023
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