Blaisdell, Gregory

Blaisdell, Gregory is an individual health care provider with primary practice located at 335 Brighton Ave Suite 200, Portland ME 04102-2363. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Blaisdell, Gregory can be contacted via phone (207) 662-8600.

Contact Information

Primary practice address
335 Brighton Ave Suite 200 Portland ME 04102-2363
Phone: (207) 662-8600
Fax: (207) 662-8668
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X MD20727 Maine
Allopathic & Osteopathic Physicians / Surgery 208600000X ML20008868 Washington
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X ME112516 Florida
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 16000 New Hampshire

Profile Details

NPI number 1689864233
LBN Legal business name Blaisdell, Gregory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2007
Last updated Oct 12th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689864233 NPPES
Florida Other 14L3J BC/BS
Florida MEDICAID 3086827 BC/BS
Florida Other PENDING BC/BS
Florida Other PENDING BC/BS
Florida MEDICAID 1689864233 BC/BS

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