Provider Demographics
NPI:1417514621
Name:BLASEIO, JULIAN (MD)
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:
Last Name:BLASEIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:505 MAINSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1208
Mailing Address - Country:US
Mailing Address - Phone:931-398-6590
Mailing Address - Fax:391-398-6597
Practice Address - Street 1:2478 NASHVILLE HWY STE A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-0634
Practice Address - Country:US
Practice Address - Phone:931-398-6590
Practice Address - Fax:931-398-6597
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-22
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN64456207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine