Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 048485 | GA |
NPI | 1013087287 |
---|---|
Provider Name | Dr. Patrick Leroy Blohm |
First Address | Savannah, GA 31405-6007 |
Second Address | Savannah, GA 31405-6007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F31783 | (02) |