Provider Demographics
NPI:1376692194
Name:BLUTE, MICHAEL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:BLUTE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:25 CROSSROADS DR STE 306
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5437
Mailing Address - Country:US
Mailing Address - Phone:602-222-1900
Mailing Address - Fax:602-557-0001
Practice Address - Street 1:20401 N 73RD ST STE 105
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4146
Practice Address - Country:US
Practice Address - Phone:480-661-2662
Practice Address - Fax:602-557-0001
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2022-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI61947208800000X
FLME127813208800000X
NE31272208800000X
AZ59763208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017275100Medicaid
FL017275100Medicaid