Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 48024 | WI |
N | 207YP0228X | Pediatric Otolaryngology | 48024 | WI |
NPI | 1316998768 |
---|---|
Provider Name | Dr. Joel H Blumin |
First Address | Milwaukee, WI 53226-3522 |
Second Address | Milwaukee, WI 53226-3522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 08/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
039906262Q | HUMANA (01) | |
1316998768 | (05) | WI |
H06164 | (02) |