Provider Demographics
NPI:1033616107
Name:DR. SCOTT W. BLUMER LLC
Entity Type:Organization
Organization Name:DR. SCOTT W. BLUMER LLC
Other - Org Name:EXCEL ENT ALLERGY AND HEARING SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SPRING
Authorized Official - Middle Name:R
Authorized Official - Last Name:BEAULIEU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-312-3100
Mailing Address - Street 1:2819 AARONWOOD AVE. NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-2371
Mailing Address - Country:US
Mailing Address - Phone:330-837-3559
Mailing Address - Fax:330-837-3052
Practice Address - Street 1:2819 AARONWOOD AVE. NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-2371
Practice Address - Country:US
Practice Address - Phone:330-837-3559
Practice Address - Fax:330-837-3052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-06
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty