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NPI Code Detail

MEDICARE: BLAIR SURGICAL ASSOCIATES PC

MEDICARE: BLAIR SURGICAL ASSOCIATES PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CI2845OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013971860
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLAIR SURGICAL ASSOCIATES PC
Provider Business Mailing Address
First Line : 2525 NINTH AVENUE
Second Line : SUITE 1B
City : ALTOONA
State : PA
Zip : 16602-2014
Country : US
Telephone Number : 814-942-6038
Fax Number : 814-942-6038
Provider Business Practice Location Address
First Line : 2525 NINTH AVENUE
Second Line : SUITE 1B
City : ALTOONA
State : PA
Zip : 16602-2014
Country : US
Telephone Number : 814-942-6038
Fax Number : 814-942-6038
Authorized Official
Title or Position : PRESIDENT CORPORATION
Name : SUBHASHIS MAITRA
Credential : MD
Telephone Number : 814-942-6038
Provider Enumeration Date : 04/17/2006
Last Update Date : 02/12/2008

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Directions to “BLAIR SURGICAL ASSOCIATES PC ” Practice Location

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