Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | SO3386 | MD |
NPI | 1306919865 |
---|---|
Provider Name | Carol Bleam |
First Address | Eldersburg, MD 21784-9276 |
Second Address | Eldersburg, MD 21784-9276 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 07/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2136292 | ALLIANCE (01) | MD |
2136292 | MAMSI (01) | MD |
2140007 | BLUE CROSS BLUE SHIELD (01) | MD |
3798356 | AETNA (01) | MD |
52185508 | UNITED HEALTH CARE (01) | MD |