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Individual

BLAINE LEE MASSEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
8333 NAAB RD STE 420, INDIANAPOLIS, IN 46260-1992
(317) 338-6024
Mailing address
8333 NAAB RD STE 420, INDIANAPOLIS, IN 46260-1992

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
02007740A
IN
208D00000X
General Practice Physician
OS020350
PA
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
04/25/2015
Last updated
06/25/2024
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