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General NPI Number Information
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NPI Number | 1649226705
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Entity Type | Individual
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Provider Name | MARK A BLAIR M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 3811 E BELL RD STE 309
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City | PHOENIX
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State | AZ
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Zip | 85032-2160
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Country | US
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Telephone | 602-971-0950
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Fax | 602-992-4971
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Provider Business Mailing Address
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Address Line | PO BOX 650886 DEPT. 41958
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City | DALLAS
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State | TX
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Zip | 75265
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Country | US
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Telephone | 805-919-0094
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Fax | 480-222-0269
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 32353
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License Number State | AZ
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