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General NPI Number Information
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NPI Number | 1174221782
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Entity Type | Individual
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Provider Name | RONALD BLASINI MD
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Gender | Male
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 755 SCOTT CIR
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City | HICKAM AFB
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State | HI
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Zip | 96853-5399
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Country | US
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Telephone | 808-448-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 755 SCOTT CIR
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City | HICKAM AFB
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State | HI
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Zip | 96853-5399
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Country | US
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Telephone | 808-448-6100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | DR0073936
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License Number State | CO
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