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

Last updated

Jun 19, 2008By the provider in NPPES

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, MDNPI 1851334817

Title

President

Phone

(208) 678-2283

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wayne H Blauer, MD

  • Family Medicine Physician
  • Burley, ID
  • NPI 1851334817
  Authorized official Same address or phone

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": []
}

• Walmart Inc. (Walmart Pharmacy 10-1900)
• Walter M. Graham, M.D.
• Bethany Walton, OTR/L
• Justin Ward, D.M.D.
• Laura Watkins, RD
• Donald L Weese Jr., MD
• Wendell Lee Wells, M.D.
• Susannah Marie West, LCPC
• Heather Westergard, APRN
• Courtney Lorrine White, LMSW

• 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.