Individual provider · Type 1 NPI

Evan Blazek

Student in an Organized Health Care Education/Training Program · Ada, OH

NPI number 1164301677 Active

Practice location

402 W College Ave Unit 2622
Ada, OH 45810-6109

Call (317) 474-5402 Map

Mailing address

617 S Gilbert St
Ada, OH 45810-1311

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1164301677

Evan Blazek's National Provider Identifier is 1164301677, issued on Aug 28, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Ada, OH. The record was last updated on Aug 28, 2025.