Healthcare Provider Details

I. General information

NPI: 1902849938
Provider Name (Legal Business Name): TAMMIE MAE BLAIR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10440 LITTLE PATUXENT PKWY STE 300
COLUMBIA MD
21044-3648
US

IV. Provider business mailing address

10440 LITTLE PATUXENT PKWY STE 300
COLUMBIA MD
21044-3648
US

V. Phone/Fax

Practice location:
  • Phone: 703-618-0111
  • Fax:
Mailing address:
  • Phone: 888-731-8994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberRN1024450
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberR248550
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number752978
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number117969
License Number StateWV
# 5
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number0024168949
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number214952
License Number StateCT
# 7
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberAPRN03987
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: