Individual
DR. MARSHA Y BLAKESLEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., D.O.
Contact information
Practice address
479 JUMPERS HOLE RD, STE 304-A, SEVERNA PARK, MD 21146-1600
(410) 544-0053
(410) 544-7830
Mailing address
479 JUMPERS HOLE RD, STE 304-A, SEVERNA PARK, MD 21146-1600
(410) 544-0053
(410) 544-7830
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
H44184
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000214001
PHCS
MD
01
—
00001181183 08
UNITED HEALTHCARE
MD
01
—
3195
COVENTRY HEALTHCARE
MD
01
—
531364 04
CAREFIRST RENDERING ID
MD
01
—
H44184
STATE LICENSE
MD
01
—
KJ46BL
CAREFIRST BCBS
MD
Enumeration date
03/27/2007
Last updated
07/09/2007
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