Provider Demographics
NPI:1245208206
Name:BLACHAR, ALEJANDRO (MD)
Entity type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:
Last Name:BLACHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4906 CREEK CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-9683
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:802 N RIVERSIDE RD
Practice Address - Street 2:STE 280
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-9794
Practice Address - Country:US
Practice Address - Phone:816-271-6518
Practice Address - Fax:816-271-6539
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001006090207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO29673022OtherBCBS KC
MO455958OtherPHP HEALTHLINK
MO10001091102OtherCHP
KS1003955050AMedicaid
MO205272503Medicaid
KS29673012OtherBCBS KS
MO5909146OtherAETNA
MO7569516002OtherCIGNA
MO701B134Medicare ID - Type Unspecified
MOF89893Medicare UPIN
MO205272503Medicaid