Healthcare Provider Details

I. General information

NPI: 1245208206
Provider Name (Legal Business Name): ALEJANDRO BLACHAR M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 09/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 N RIVERSIDE RD STE 280
SAINT JOSEPH MO
64507-9794
US

IV. Provider business mailing address

4906 CREEK CROSSING DR
SAINT JOSEPH MO
64507-9683
US

V. Phone/Fax

Practice location:
  • Phone: 816-271-6518
  • Fax: 816-271-6539
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number2001006090
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: