Individual provider Active NPI

Mark G Blaskis, MD

  • Dermatology Physician
  • Columbia, SC
National Provider Identifier
1841259124
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
17720 Issued in SC
Practice address
1706 Saint Julian PL
Columbia, SC 29204-2410
Phone
(803) 771-7506
Fax
(803) 771-9455
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 17720 SC Primary

Addresses

Primary practice location

1706 Saint Julian PL
Columbia, SC 29204-2410

Mailing address

1706 Saint Julian PL
Columbia, SC 29204-2410
Phone (803) 771-7506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17720SCMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Dermatology GRP Dermatology CurrentSince Jan 27, 1995 Accepting new patients

Locations

1706 Saint Julian Pl
Columbia, SC 29204
Phone (803) 771-7506

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1841259124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 SAINT JULIAN PL",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042410",
            "telephone_number": "803-771-7506",
            "fax_number": "803-771-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 SAINT JULIAN PL",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042410",
            "telephone_number": "803-771-7506",
            "fax_number": "803-771-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASKIS",
        "first_name": "MARK",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "17720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.