Provider Demographics
NPI:1598707770
Name:BLUMER, DANIEL S (DO)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:S
Last Name:BLUMER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2662 COLUMBUS RD NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44705-3705
Mailing Address - Country:US
Mailing Address - Phone:330-453-2044
Mailing Address - Fax:330-453-1309
Practice Address - Street 1:2662 COLUMBUS RD NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44705-3705
Practice Address - Country:US
Practice Address - Phone:330-453-8168
Practice Address - Fax:330-453-1309
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34003182207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0467294Medicaid
OHBL0506261Medicare ID - Type Unspecified