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Individual

BLAIR E HONTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 582-2182
Mailing address
2005 WALLACE ST, UNIT #1, PHILADELPHIA, PA 19130-3221
(215) 582-2182

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
390200000X
PA
207P00000X
Emergency Medicine Physician
Primary
P0228
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
285256804
TX
01
P01012688
RAILROAD
TX
Enumeration date
06/18/2007
Last updated
05/24/2012
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