David W Blodgett, M.D. PLLC

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

License

4301075561 Issued in MI

Legal business name

DAVID W BLODGETT, M.D. PLLC

Practice address

839 Randall CT
Birmingham, MI 48009-1368

Phone

(248) 761-5573

Fax

(248) 593-9567

NPI assigned

Aug 10, 2011

Organization subpart

No

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

Authorized official

Name

Dr. David Blodgett, M.D.

Title

Owner

Phone

(248) 761-5573

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312934400000",
    "number": "1285913020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 RANDALL CT",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480091368",
            "telephone_number": "248-761-5573",
            "fax_number": "248-593-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 RANDALL CT",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480091368",
            "telephone_number": "248-761-5573",
            "fax_number": "248-593-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID W BLODGETT, M.D. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-10",
        "last_updated": "2011-08-10",
        "status": "A",
        "authorized_official_last_name": "BLODGETT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-761-5573",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "MI",
            "license": "4301075561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor Barry Dauphin, PH.D.
• David Bastianelli, DDS, PLLC
• David J Schwartz PHD LP LLC
• David P. Stanislaw, Jr., M.S.W., P.C.
• David V Spurlin, M.D., P.L.L.C. (Pinnacle Dermatology)
• Heather Kristin Dean, MUSIC THERAPIST
• Allan Dehorn, PHD
• Kennidy Denis
• Gregory Paul Derderian, D.O.
• Dermatology Associates PC

• Ophthalmologic Surgery Clinic/Center in Birmingham, MI
• Providers in Birmingham, MI by specialty
• Ophthalmologic Surgery Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; 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.