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General NPI Number Information
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NPI Number | 1780678599
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Entity Type | Individual
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Provider Name | LEONARD PAUL BLASS M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1350 E MARKET ST
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City | WARREN
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State | OH
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Zip | 44483-6608
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Country | US
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Telephone | 330-841-9699
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Fax | 330-841-9569
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Provider Business Mailing Address
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Address Line | 340 N LINDEN CT
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City | WARREN
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State | OH
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Zip | 44484-6038
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Country | US
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Telephone | 330-841-9609
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Fax | 330-841-9569
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 35-04-5525-B
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License Number State | OH
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