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NPI Code Detail

MEDICARE: DR. G BLAIR DOWDEN III M.D.

MEDICARE: DR. G BLAIR DOWDEN III M.D.
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
1207Q00000XFamily Medicine Physician4301088847MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10740206OTHERMIBCBSM
20741095OTHERMIBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750379194
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. G BLAIR DOWDEN III M.D.
Provider Business Mailing Address
First Line : 4071 24TH AVE
Second Line :
City : FORT GRATIOT
State : MI
Zip : 48059-3801
Country : US
Telephone Number : 810-824-4222
Fax Number : 810-824-4220
Provider Business Practice Location Address
First Line : 4071 24TH AVE
Second Line :
City : FORT GRATIOT
State : MI
Zip : 48059-3801
Country : US
Telephone Number : 810-824-4222
Fax Number : 810-824-4220
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2005
Last Update Date : 09/07/2012

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