Provider Demographics
NPI:1508824475
Name:BLUMENTHAL, NINA CAROL (MD)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:CAROL
Last Name:BLUMENTHAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:145 FAUNCE CORNER MALL RD
Mailing Address - Street 2:STE J
Mailing Address - City:N DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1263
Mailing Address - Country:US
Mailing Address - Phone:508-993-7601
Mailing Address - Fax:
Practice Address - Street 1:145 FAUNCE CORNER MALL RD
Practice Address - Street 2:STE J
Practice Address - City:N DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1263
Practice Address - Country:US
Practice Address - Phone:508-993-7601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA74616207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology