Individual
DR. MARK A BLASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 JOHN DEERE ROAD, SUITE 200, MOLINE, IL 61265-6897
(309) 779-4200
(309) 779-4305
Mailing address
600 JOHN DEERE ROAD, SUITE 200, MOLINE, IL 61265-6897
(309) 779-4200
(309) 779-4305
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
0360778877
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036078877
—
IL
01
—
370002995
RR MEDICARE
IL
Enumeration date
01/13/2006
Last updated
06/11/2008
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