MEDICARE: DR. MARK E BLAIR MD

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	2084P0800X	Psychiatry Physician	35081181	OH

General Provider Information

NPI Number	:	1194755504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK E BLAIR MD

Provider Business Mailing Address
First Line	:	500 E MAIN ST STE 130
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-5369
Country	:	US
Telephone Number	:	614-933-4200
Fax Number	:	614-407-7622

Provider Business Practice Location Address
First Line	:	500 E MAIN ST STE 130
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-5369
Country	:	US
Telephone Number	:	614-933-4200
Fax Number	:	614-407-7622

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	12/09/2025

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