Provider Demographics
NPI:1154502896
Name:BLALOCK, ELIZABETH U (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:U
Last Name:BLALOCK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:459 PATTERSON RD
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1522
Mailing Address - Country:US
Mailing Address - Phone:808-433-0028
Mailing Address - Fax:808-433-7744
Practice Address - Street 1:459 PATTERSON RD
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1522
Practice Address - Country:US
Practice Address - Phone:808-433-0028
Practice Address - Fax:808-433-7744
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-23
Last Update Date:2021-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI140072084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology