MR. BARTON JEROME BLUM


Address: E1803 Melody Lane, Waupaca, WI 54981
Phone: 7152588414

MR. BARTON JEROME BLUM (NPI# 1629387006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629387006
Entity Type Individual
Full Name MR. BARTON JEROME BLUM
Credential MD
Practice Address E1803 Melody Lane
Waupaca
WI 54981
Practice Telephone 7152588414
Mailing Telephone 7152588414
Enumeration Date 2010-10-01
Last Update Date 2010-10-01
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208D00000X General Practice 21229-020 WI Allopathic & Osteopathic Physicians

Office Location

Street Address E1803 MELODY LANE
City WAUPACA
State WI
Zip Code 54981

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Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

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Competitor

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City WAUPACA
Zip Code 54981

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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