Provider Demographics
NPI:1023051059
Name:BLAIR, DONNA J (MD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:J
Last Name:BLAIR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1 CAYLOR NICKEL SQ
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-2529
Mailing Address - Country:US
Mailing Address - Phone:260-824-3500
Mailing Address - Fax:260-919-3419
Practice Address - Street 1:1 CAYLOR NICKEL SQ
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-2529
Practice Address - Country:US
Practice Address - Phone:260-824-3500
Practice Address - Fax:260-919-3419
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-10-12
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Provider Licenses
StateLicense IDTaxonomies
IN01037203A207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN911080BBBMedicare PIN
B46709Medicare UPIN