Wayne H Blauer MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M-4491 Issued in ID

Legal business name

WAYNE H BLAUER MD PA

Practice address

1501 Hiland Ave
Ste L3
Burley, ID 83318-2682

Phone

(208) 678-2283

Fax

(208) 677-2483

NPI assigned

Oct 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Wayne H Blauer, MD

Title

President

Phone

(208) 678-2283

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1184812232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 HILAND AVE",
            "address_2": "STE L3",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182682",
            "telephone_number": "208-678-2283",
            "fax_number": "208-677-2483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HILAND AVE",
            "address_2": "STE L3",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182682",
            "telephone_number": "208-678-2283",
            "fax_number": "208-677-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE H BLAUER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-12",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "BLAUER",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-678-2283",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-4491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Burley, ID
• Providers in Burley, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.