Provider Demographics
NPI:1275711541
Name:BLAIR, ANDREW DAVID (PSYD)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:DAVID
Last Name:BLAIR
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 CATHEDRAL ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5442
Mailing Address - Country:US
Mailing Address - Phone:410-837-2050
Mailing Address - Fax:410-837-7793
Practice Address - Street 1:1001 CATHEDRAL ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5442
Practice Address - Country:US
Practice Address - Phone:410-837-2050
Practice Address - Fax:410-837-7793
Is Sole Proprietor?:No
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04494103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical