Organization
DAVID W BLODGETT MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID W BLODGETT M.D. (OWNER)
(248) 761-5573
Entity
Organization
Contact information
Practice address
375 BARCLAY DR., ROCHESTER HILLS, MI 48307
(248) 852-3636
(248) 852-3631
Mailing address
839 RANDALL CT, BIRMINGHAM, MI 48009-1368
(248) 761-5573
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301075561
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005491912
—
MI
Enumeration date
11/30/2011
Last updated
11/30/2011
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