Provider Demographics
NPI:1871704957
Name:BLYDEN, DIONNE JOSEPHA (MD)
Entity type:Individual
Prefix:DR
First Name:DIONNE
Middle Name:JOSEPHA
Last Name:BLYDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1124 MARYLAND ST
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48230-1307
Mailing Address - Country:US
Mailing Address - Phone:313-821-5606
Mailing Address - Fax:
Practice Address - Street 1:HENRY FORD HOSPITAL
Practice Address - Street 2:2799 W. GRAND BLVD.
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-3056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301077642208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery