Provider Demographics
NPI:1932245719
Name:BLUHM, RENATA ELIZABETH (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:RENATA
Middle Name:ELIZABETH
Last Name:BLUHM
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 W CALDWELL ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-2910
Mailing Address - Country:US
Mailing Address - Phone:615-316-0100
Mailing Address - Fax:615-872-0088
Practice Address - Street 1:40 W CALDWELL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-2910
Practice Address - Country:US
Practice Address - Phone:615-316-0100
Practice Address - Fax:615-872-0088
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000019042207R00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3036293Medicaid
TN103I110373Medicare PIN
TN3036293Medicaid