Provider Demographics
NPI:1891781712
Name:BLAIR, HARRY JOSEPH JR (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:JOSEPH
Last Name:BLAIR
Suffix:JR
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 1:2000 COURT ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-3703
Mailing Address - Country:US
Mailing Address - Phone:989-793-1381
Mailing Address - Fax:989-793-8909
Practice Address - Street 1:2000 COURT ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3703
Practice Address - Country:US
Practice Address - Phone:989-793-1381
Practice Address - Fax:989-793-8909
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301035302207RC0200X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4258930Medicaid
MI2100130Medicaid
MIHB035302OtherBCBSM LICENCE #
E41232Medicare UPIN
MI4258930Medicaid
0737340Medicare ID - Type Unspecified