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General NPI Number Information
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NPI Number | 1982931275
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Entity Type | Organization
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Legal Business Name | DAVID H. BLATT, M.D., P.C.
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Dates
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Enumeration Date | 11/09/2009
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Last Update Date | 11/09/2009
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Provider Practice Location Address
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Address Line | 350 NW ELKS DR SUITE 202
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City | CORVALLIS
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State | OR
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Zip | 97330-3885
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Country | US
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Telephone | 541-758-8464
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Fax | 541-758-8460
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Provider Business Mailing Address
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Address Line | 350 NW ELKS DR SUITE 202
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City | CORVALLIS
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State | OR
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Zip | 97330-3885
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Country | US
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Telephone | 541-758-8464
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Fax | 541-758-8460
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID HOWARD BLATT
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Credential | M.D.
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Telephone | 541-758-8464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | MD16833
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License Number State | OR
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