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General NPI Number Information
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NPI Number | 1497969307
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Entity Type | Individual
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Provider Name | ROBERT MICHAEL BLAESE MD
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Gender | Male
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 12/21/2025
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Provider Practice Location Address
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Address Line | CLINICAL CENTER N I H 10 CENTER DR
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City | BETHESDA
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State | MD
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Zip | 20892-0001
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Country | US
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Telephone | 443-220-2067
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Fax |
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Provider Business Mailing Address
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Address Line | 48 WOODSIDE LN
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City | NEW HOPE
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State | PA
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Zip | 18938-9281
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Country | US
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Telephone | 215-862-6374
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Fax | 215-863-6473
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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 | 2080I0007X
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Taxonomy Name | Pediatric Clinical & Laboratory Immunology Physician
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License Number | D0026255
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License Number State | MD
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