Provider Demographics
NPI:1881757441
Name:BLUHM, ANDREW E (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:E
Last Name:BLUHM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38661 LAYCOCK FARM CT
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:VA
Mailing Address - Zip Code:20158-9448
Mailing Address - Country:US
Mailing Address - Phone:540-338-3970
Mailing Address - Fax:
Practice Address - Street 1:44340 PREMIER PLZ
Practice Address - Street 2:SUITE 100
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5025
Practice Address - Country:US
Practice Address - Phone:703-729-8700
Practice Address - Fax:703-729-5300
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401007764174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA067698OtherANTHEM BCBS PROVIDER NUMB
VA066607OtherANTHEM BCBS PROVIDER NUM
VAU50702Medicare UPIN