Provider Demographics
NPI:1972859320
Name:TULL, BLAIR HAWS (MD)
Entity Type:Individual
Prefix:DR
First Name:BLAIR
Middle Name:HAWS
Last Name:TULL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:250 SAN JOSE ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3901
Mailing Address - Country:US
Mailing Address - Phone:831-649-1000
Mailing Address - Fax:831-649-4962
Practice Address - Street 1:250 SAN JOSE ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901
Practice Address - Country:US
Practice Address - Phone:831-424-7389
Practice Address - Fax:831-758-0547
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2018-05-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA154598207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX462172YNQ4Medicare PIN