Provider Demographics
NPI:1467526418
Name:BLUFORD, TAMENIA BLUFORD (PA)
Entity Type:Individual
Prefix:
First Name:TAMENIA
Middle Name:BLUFORD
Last Name:BLUFORD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GENERAL DELIVERY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-9999
Mailing Address - Country:US
Mailing Address - Phone:615-227-1076
Mailing Address - Fax:
Practice Address - Street 1:4 N BAY XING
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-7507
Practice Address - Country:US
Practice Address - Phone:615-227-1076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCA570363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical