Provider Demographics
NPI:1205872447
Name:BLUME, JAMES H JR (DO)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:H
Last Name:BLUME
Suffix:JR
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:PO BOX 153
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:WV
Mailing Address - Zip Code:24935-0153
Mailing Address - Country:US
Mailing Address - Phone:304-466-1152
Mailing Address - Fax:304-466-1192
Practice Address - Street 1:WV RT 12
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:WV
Practice Address - Zip Code:24935-0153
Practice Address - Country:US
Practice Address - Phone:304-466-1152
Practice Address - Fax:304-466-1192
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV1096207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001721352OtherBCBS
4415536OtherAETNA
WV0041145000Medicaid
WV080032127OtherRR MEDICARE
E65354Medicare UPIN
WV0041145000Medicaid