Provider Demographics
NPI:1922325679
Name:BLAU, ADAM (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:BLAU
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Gender:M
Credentials:MD
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Mailing Address - Street 1:91 MONTVALE AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3649
Mailing Address - Country:US
Mailing Address - Phone:781-620-4984
Mailing Address - Fax:781-438-3125
Practice Address - Street 1:91 MONTVALE AVE STE 208
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-3649
Practice Address - Country:US
Practice Address - Phone:781-620-4984
Practice Address - Fax:781-438-3125
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2019-10-03
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Provider Licenses
StateLicense IDTaxonomies
MA271330208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery