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Contact Information

MARY C BLAZEK, MD
4260 PLYMOUTH RD
ANN ARBOR, MI48109-2700
 Phone: 734-936-4400
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for MARY C BLAZEK · (Female)

NPI # 1831240118
Status Active
Credentials MD
Entity Individual
Enumeration date 01/15/2007
Last updated 09/01/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301078784
  • MI Medicaid 104334765
  • MI Other 260H161260 BCBS GRP
Hospital affiliation(s)
  • UNIVERSITY OF MICHIGAN HEALTH SYSTEM - (Acute Care)
    1500 E MEDICAL CENTER DRIVE, SPC 5474
    ANN ARBOR, MI 48109
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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