Provider Demographics
NPI:1003911272
Name:BLASCHKE, TERRENCE FRANCIS (MD)
Entity Type:Individual
Prefix:PROF
First Name:TERRENCE
Middle Name:FRANCIS
Last Name:BLASCHKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:855 ALLARDICE WAY
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-1050
Mailing Address - Country:US
Mailing Address - Phone:650-725-4632
Mailing Address - Fax:650-725-8020
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:S-009 SUMC
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-725-4632
Practice Address - Fax:650-725-8020
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG22733207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine