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General NPI Number Information
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NPI Number | 1508975632
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Entity Type | Individual
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Provider Name | CAROL L BLAND MD
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 2458 NEW MARKET BANTA RD
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City | WEST ALEXANDRIA
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State | OH
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Zip | 45381-9708
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Country | US
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Telephone | 937-371-7490
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Fax | 937-632-2606
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Provider Business Mailing Address
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Address Line | 2458 NEW MARKET BANTA RD
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City | WEST ALEXANDRIA
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State | OH
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Zip | 45381-9708
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Country | US
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Telephone | 937-371-7490
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Fax | 937-632-2606
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35073056B
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License Number State | OH
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