Individual ProviderTatjana BlazinInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address3601 W 13 Mile Rd, Royal Oak, MI 48073-6712(248) 551-3000PECOS EnrollmentBased on the most recent information from CMS, provider Tatjana Blazin is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 9:21 AM.Profile DetailsProvider ID1083359152Provider TypeIndividualFull NameBlazin, TatjanaCredentialMDGenderFemaleSole ProprietorNoEnumeration Date5/3/2022Last Updated5/3/2022Contact InformationPractice LocationPractice Address3601 W 13 Mile Rd, Royal Oak, MI 48073-6712Phone(248) 551-3000Fax(248) 551-9425Mailing LocationMailing Address3601 W 13 Mile Rd, Royal Oak, MI 48073-6712Phone(248) 551-3000Fax(248) 551-9425Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense4351049284Michigan