Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 239339 | MA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD000045204 | WA |
NPI | 1689649006 |
---|---|
Provider Name | Dr. Eric Michael Bluman |
First Address | Jamaica Plain, MA 02130 |
Second Address | Jamaica Plain, MA 02130 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2006 |
Last Update Date | 04/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110083079A | (05) | MA |
A00000 | (02) | MA |
H79651 | (02) | RI |