Provider Demographics
NPI:1043284300
Name:TUFT, BLAINE A (DO)
Entity Type:Individual
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First Name:BLAINE
Middle Name:A
Last Name:TUFT
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Gender:M
Credentials:DO
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Mailing Address - Street 1:1604 WESTERLY CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-1285
Mailing Address - Country:US
Mailing Address - Phone:757-963-0045
Mailing Address - Fax:757-953-0868
Practice Address - Street 1:45 PINE ST
Practice Address - Street 2:1ST MED GROUP/SGHC
Practice Address - City:LANGLEY AFB
Practice Address - State:VA
Practice Address - Zip Code:23665-2025
Practice Address - Country:US
Practice Address - Phone:757-953-2983
Practice Address - Fax:757-953-0868
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2021-11-23
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Provider Licenses
StateLicense IDTaxonomies
IDO-1912080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology