Provider Demographics
NPI:1467483974
Name:ALLERGY & ASTHMA CARE, PLC
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA CARE, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:BLAISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-757-6100
Mailing Address - Street 1:7205 WOLF RIVER BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1746
Mailing Address - Country:US
Mailing Address - Phone:901-757-6100
Mailing Address - Fax:901-757-6109
Practice Address - Street 1:7205 WOLF RIVER BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1746
Practice Address - Country:US
Practice Address - Phone:901-757-6100
Practice Address - Fax:901-757-6109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3371189Medicare ID - Type Unspecified