Herbert Milton Blair III, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0613381 Issued in MI

Practice address

1560 E Sherman Blvd
West Shore Professional Building
Muskegon, MI 49444-1867

Phone

(231) 733-4781

Fax

(231) 733-8409

NPI assigned

Jul 28, 2006

Last updated

Jul 14, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1992719389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E SHERMAN BLVD",
            "address_2": "WEST SHORE PROFESSIONAL BUILDING",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441867",
            "telephone_number": "231-733-4781",
            "fax_number": "231-733-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 E SHERMAN BLVD",
            "address_2": "WEST SHORE PROFESSIONAL BUILDING",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441867",
            "telephone_number": "231-733-4781",
            "fax_number": "231-733-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "HERBERT",
        "middle_name": "MILTON",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "0613381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0706133812",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1061584",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS STATE LICENSE NUMBER",
            "identifier": "HB028089",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Sue Bisson
• Benjamin Ray Black, DO
• Miranda Rene Blackbourn
• Shantell Blackman, RMA
• Cynthia Lynn Blair, RN
• Shonie Rena Blake
• Jessica Blanchard, CPRC
• Saundra L Blanchard, MD
• Terryce A Blanchard, DO
• Taylor William Blanchette, PA-C

• Dermatology Physician in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; 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.