Individual
BLAISE MICHAEL LAMPUGNALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6855 SPRING VALLEY DR STE 110, HOLLAND, OH 43528-9374
(216) 438-0283
Mailing address
6855 SPRING VALLEY DR STE 110, HOLLAND, OH 43528-9374
(216) 438-0283
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.006407RX
OH
363A00000X
Physician Assistant
PA54121
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50.006407RX
OHIO PA LICENSE
OH
Enumeration date
12/30/2016
Last updated
07/13/2021
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