MEDICARE: JOHN BLEBEA 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	208600000X	Surgery Physician	28809	OK
2	208600000X	Surgery Physician	4301111451	MI
3	2086S0129X	Vascular Surgery Physician	28809	OK
4	2086S0129X	Vascular Surgery Physician	4301111451	MI

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386632313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN BLEBEA MD

Provider Business Mailing Address
First Line	:	1000 HOUGHTON AVE.
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48602
Country	:	US
Telephone Number	:	989-583-6800
Fax Number	:	989-583-6955

Provider Business Practice Location Address
First Line	:	912 S WASHINGTON AVE
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48601-2564
Country	:	US
Telephone Number	:	918-744-3523
Fax Number	:	918-744-3463

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

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	03/31/2021

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Directions to “ JOHN BLEBEA MD” Practice Location

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