Provider Demographics
NPI:1770788960
Name:BLAZES, DAVID (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:BLAZES
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AMERICAN EMBASSY
Mailing Address - Street 2:UNIT 3800
Mailing Address - City:APO
Mailing Address - State:AA
Mailing Address - Zip Code:34031
Mailing Address - Country:PE
Mailing Address - Phone:511-562-3848
Mailing Address - Fax:
Practice Address - Street 1:AMERICAN EMBASSY
Practice Address - Street 2:UNIT 3800
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:34031
Practice Address - Country:PE
Practice Address - Phone:511-562-3848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0051503207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease