Provider Demographics
NPI:1780644344
Name:BLUNT, AMY (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BLUNT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18101 PRINCE PHILIP DR STE 5100
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1514
Mailing Address - Country:US
Mailing Address - Phone:301-570-7424
Mailing Address - Fax:301-570-7425
Practice Address - Street 1:18101 PRINCE PHILIP DR STE 5100
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1514
Practice Address - Country:US
Practice Address - Phone:301-570-7424
Practice Address - Fax:301-570-7425
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0056996207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC01190007OtherBC DC/METRO
MD389528OtherUNITED HEALTHCARE
MD727500500Medicaid
MD61177902OtherBCBS OF MD
DC01190007OtherBC DC/METRO
MDG50856Medicare UPIN
MD727500500Medicaid