Provider Demographics
NPI:1427190727
Name:BLUME, DOUGLAS N (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:N
Last Name:BLUME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 S COURT ST STE F
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-4931
Mailing Address - Country:US
Mailing Address - Phone:559-734-9244
Mailing Address - Fax:559-734-6932
Practice Address - Street 1:1700 S COURT ST STE F
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-4931
Practice Address - Country:US
Practice Address - Phone:559-734-5674
Practice Address - Fax:559-734-1787
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1273402085R0202X
CAA966412085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology