Provider Demographics
NPI:1225610546
Name:WILLIAM A. BLUME, MD
Entity Type:Organization
Organization Name:WILLIAM A. BLUME, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-422-7212
Mailing Address - Street 1:4501 N 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-3529
Mailing Address - Country:US
Mailing Address - Phone:812-422-7212
Mailing Address - Fax:812-422-7326
Practice Address - Street 1:4501 N 4TH AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-3529
Practice Address - Country:US
Practice Address - Phone:812-422-7212
Practice Address - Fax:812-422-7326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-26
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty