MEDICARE: MICHAEL BLAESS DO

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	207Q00000X	Family Medicine Physician	03085	IA
2	207Q00000X	Family Medicine Physician	DO-03085	IA

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	:	1730197476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL BLAESS DO

Provider Business Mailing Address
First Line	:	PO BOX 1475
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50305-1475
Country	:	US
Telephone Number	:	515-643-0833
Fax Number	:	515-643-0933

Provider Business Practice Location Address
First Line	:	1350 DES MOINES ST STE 110
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50309-5507
Country	:	US
Telephone Number	:	515-643-0833
Fax Number	:	515-643-0933

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

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	03/29/2022

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Directions to “ MICHAEL BLAESS DO” Practice Location

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