| Marie Blaize, | |
|
705 Dixie St, Carrollton, GA 30117-3818 | |
| (770) 838-8824 | |
| (770) 838-8563 |
| Full Name | Marie Blaize |
|---|---|
| Gender | Female |
| Speciality | Hospitalist |
| Experience | 12 Years |
| Location | 705 Dixie St, Carrollton, Georgia |
| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275979205 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD61514731 (Washington) | Secondary |
| 207R00000X | Internal Medicine | 076302 (Georgia) | Secondary |
| 208M00000X | Hospitalist | 076302 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Tanner Medical Center - Carrollton | Carrollton, GA | Hospital |
| Whidbeyhealth Medical Center | Coupeville, WA | Hospital |
| Tanner Medical Center Villa Rica | Villa rica, GA | Hospital |
| Oak Valley Hospital District | Oakdale, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Apogee Medical Group Georgia | 4587676945 | 105 |
| South Sound Inpatient Physicians Pllc | 5991618738 | 381 |
| Inpatient Specialists Of California Pc | 3476864448 | 308 |
| Entity Name | Apogee Medical Group Georgia |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629025143 PECOS PAC ID: 4587676945 Enrollment ID: O20060629000214 |
| Entity Name | Utm Of Georgia Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1255893038 PECOS PAC ID: 5991138307 Enrollment ID: O20191125002037 |
| Mailing Address | Practice Location Address |
|---|---|
| Marie Blaize, 119 Ambulance Dr, Suite 202, Carrollton, GA 30117-3857 Ph: (770) 838-8824 | Marie Blaize, 705 Dixie St, Carrollton, GA 30117-3818 Ph: (770) 838-8824 |
Steven Allen Eubanks Jr., M.D. Hospitalist Medicare: Medicare Enrolled Practice Location: 148 Clinic Ave, Carrollton, GA 30117 Phone: 770-838-8640 Fax: 770-838-8650 | |
Vaughn S Clagette, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 705 Dixie St, Carrollton, GA 30117 Phone: 770-838-8929 Fax: 770-838-8930 | |
Dr. Suzanne Cahill Manley, M.D. Hospitalist Medicare: Medicare Enrolled Practice Location: 148 Clinic Ave, Carrollton, GA 30117 Phone: 770-838-8640 Fax: 770-838-8650 | |
Dr. Holley Elizabeth Beam, MD Hospitalist Medicare: Medicare Enrolled Practice Location: 148 Clinic Ave, Carrollton, GA 30117 Phone: 770-838-8640 Fax: 770-838-8650 |