Provider Demographics
NPI:1821199647
Name:BLAIR, PAUL ALEX (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ALEX
Last Name:BLAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3667 TEAYS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9658
Mailing Address - Country:US
Mailing Address - Phone:304-201-3223
Mailing Address - Fax:304-201-6555
Practice Address - Street 1:3667 TEAYS VALLEY RD
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9658
Practice Address - Country:US
Practice Address - Phone:304-201-3223
Practice Address - Fax:304-201-6555
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV11537207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVA72592Medicare UPIN
WV0613221Medicare PIN