Provider Demographics
NPI:1760529481
Name:BLATMAN, HAL SAMUEL (MD)
Entity Type:Individual
Prefix:MR
First Name:HAL
Middle Name:SAMUEL
Last Name:BLATMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3460 GREENFIELD CT
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-9517
Mailing Address - Country:US
Mailing Address - Phone:513-677-3787
Mailing Address - Fax:513-677-9656
Practice Address - Street 1:10653 TECHWOOD CIR
Practice Address - Street 2:SUITE 101
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-2833
Practice Address - Country:US
Practice Address - Phone:513-956-3200
Practice Address - Fax:513-956-3202
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-76322083P0500X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Not Answered208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000015391OtherANTHEM
OH0653056Medicaid
OHA15167Medicare UPIN
OHBL0515763Medicare ID - Type Unspecified