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Individual

DR. WAYNE H BLAUER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1501 HILAND AVE, BURLEY, ID 83318-2688
(208) 678-2283
(208) 677-6059
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
(208) 678-2283

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M4491
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010003657
BLUE SHIELD OF IDAHO
ID
05
002576000
ID
01
DBBE9
BLUE CROSS OF IDAHO
ID
Enumeration date
06/14/2006
Last updated
08/16/2021
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