Organization
BLAIR MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L. BRYAN (PROJECTS MANAGER)
(814) 949-7621
Entity
Organization
Contact information
Practice address
620 HOWARD AVE, OP-2, ALTOONA, PA 16601-4804
(814) 889-6980
(814) 889-6994
Mailing address
1414 9TH AVE, STATION MEDICAL CENTER, ALTOONA, PA 16602-2415
(814) 946-1655
(814) 949-7616
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028095
HIGHMARK GROUP NUMBER
PA
05
—
1007393100018
—
PA
05
—
1007393100022
—
PA
05
—
1007393100101
—
PA
01
—
1015565
GATEWAY CARDIOLOGY
PA
Enumeration date
02/14/2007
Last updated
08/08/2007
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