MEDICARE: GUY L. BLASER DO, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174583736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUY L. BLASER DO, INC

Provider Business Mailing Address
First Line	:	2400 WALES AVE NW STE F
Second Line	:
City	:	MASSILLON
State	:	OH
Zip	:	44646-2366
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 WALES AVE NW STE F
Second Line	:
City	:	MASSILLON
State	:	OH
Zip	:	44646-2366
Country	:	US
Telephone Number	:	330-880-0988
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GUY BLASER
Credential	:	DO
Telephone Number	:	330-880-0988

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	09/28/2015

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