Provider Demographics
NPI:1912137431
Name:BLUM, EMILY (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:BLUM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1930 BRANNAN RD
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-4310
Mailing Address - Country:US
Mailing Address - Phone:678-284-4040
Mailing Address - Fax:678-284-4078
Practice Address - Street 1:5730 GLENRIDGE DR STE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5579
Practice Address - Country:US
Practice Address - Phone:404-252-5206
Practice Address - Fax:404-252-1268
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0782472088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology