Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 0101028776 | VA |
NPI | 1093792517 |
---|---|
Provider Name | Dr. Michael Z Blumberg |
First Address | Richmond, VA 23229-4938 |
Second Address | Richmond, VA 23229-4938 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2005 |
Last Update Date | 16/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006783899 | (05) | VA |
00Y217A01 | MEDICARE PTAN (01) | VA |
025567 | ANTHEM (01) | VA |
030001976 | RAILROAD MEDICARE (01) | VA |
224950 | MAMSI (01) | VA |
45713 | SENTERA (01) | VA |
59480 | SOUTHERN HEALTH (01) | VA |
726675 | AETNA USHC (01) | VA |