Provider Demographics
NPI:1629033931
Name:BLAIR, FRANK MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:MICHAEL
Last Name:BLAIR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:F.
Other - Middle Name:MICHAEL
Other - Last Name:BLAIR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:73 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-1963
Mailing Address - Country:US
Mailing Address - Phone:781-749-3365
Mailing Address - Fax:781-749-6262
Practice Address - Street 1:73 SUMMER ST
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-1963
Practice Address - Country:US
Practice Address - Phone:781-749-3365
Practice Address - Fax:781-749-6262
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA426111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA9909OtherHARVARD PILGRIM
MABLY35255OtherBLUE CROSS BLUE SHIELD
MA717843OtherTUFTS HEALTH PLAN
MA717843OtherTUFTS HEALTH PLAN