Provider Demographics
NPI:1215729587
Name:BLAIR, INGER
Entity type:Individual
Prefix:MS
First Name:INGER
Middle Name:
Last Name:BLAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 ORCHARD LAKE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:SYLVAN LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48320-1613
Mailing Address - Country:US
Mailing Address - Phone:248-682-0088
Mailing Address - Fax:248-682-6044
Practice Address - Street 1:2360 ORCHARD LAKE RD STE 1052360
Practice Address - Street 2:
Practice Address - City:SYLVAN LAKE
Practice Address - State:MI
Practice Address - Zip Code:48320-1613
Practice Address - Country:US
Practice Address - Phone:248-682-0088
Practice Address - Fax:248-682-6044
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty