Provider Demographics
NPI:1992853725
Name:BLUME, NATE ADAM (DC)
Entity Type:Individual
Prefix:DR
First Name:NATE
Middle Name:ADAM
Last Name:BLUME
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9745 FALL CREEK RD STE 700
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-4729
Mailing Address - Country:US
Mailing Address - Phone:317-842-5100
Mailing Address - Fax:
Practice Address - Street 1:9745 FALL CREEK RD STE 700
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-4729
Practice Address - Country:US
Practice Address - Phone:317-842-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002031A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
INU94273Medicare UPIN
IN201520AMedicare ID - Type Unspecified