Blaise, Marlene Louise

Blaise, Marlene Louise is an sole proprietor health care provider with primary practice located at 3400-C Old Milton Pkwy Suite 325, Alpharetta GA 30005-4433. She recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as her primary health care specialty. Blaise, Marlene Louise can be contacted via phone (678) 762-0910.

Contact Information

Primary practice address
3400-C Old Milton Pkwy Suite 325 Alpharetta GA 30005-4433
Phone: (678) 762-0910
Fax: (678) 762-0920
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 48028 Georgia

Profile Details

NPI number 1477587822
LBN Legal business name Blaise, Marlene Louise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 10th, 2006
Last updated Apr 22nd, 2008 - about 18 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 1477587822 NPPES
Georgia MEDICAID 000850132B

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