Individual
DANIEL ANTHONY BLAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
431 MEADOWLARK ST, SHAW AFB, SC 29152-5019
(803) 885-7976
Mailing address
431 MEADOWLARK ST, SHAW AFB, SC 29152-5019
(330) 858-3514
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
09219
OH
363LF0000X
Family Nurse Practitioner
RN279151
OH
Other
Enumeration date
09/28/2006
Last updated
03/17/2018
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