Blazek, Mary Carol

Blazek, Mary Carol is an individual health care provider with primary practice located at 4260 Plymouth Rd , Ann Arbor MI 48109-2700. She recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Geriatric Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Blazek, Mary Carol can be contacted via phone (734) 936-4400.

Contact Information

Primary practice address
4260 Plymouth Rd Ann Arbor MI 48109-2700
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 4301078784 Michigan
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 4301078784 Michigan
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X 4301078784 Michigan

Profile Details

NPI number 1831240118
LBN Legal business name Blazek, Mary Carol
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 15th, 2007
Last updated Sep 1st, 2010 - about 14 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 1831240118 NPPES
Michigan MEDICAID 104334765
Michigan Other 260H161260

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