1588699235 NPI number — DR. ARTHUR BLUMER M.D.

Table of content: DR. ARTHUR BLUMER M.D. (NPI 1588699235)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588699235 NPI number — DR. ARTHUR BLUMER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BLUMER
Provider First Name:
ARTHUR
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588699235
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
340 N MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTHINGTON
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06489-2529
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-628-5767
Provider Business Mailing Address Fax Number:
860-628-0218

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
340 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTHINGTON
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06489-2529
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-628-5767
Provider Business Practice Location Address Fax Number:
860-628-0218
Provider Enumeration Date:
07/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2080A0000X , with the licence number:  15074 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 010015074CT04 . This is a "ANTHEM" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 2603885 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 0573664004 . This is a "CIGNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P07737 . This is a "COMMUNITY HEALTH NETWORK" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 00115074703 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: ORO389 . This is a "HEALTHNET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 020921 . This is a "CONECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P379333 . This is a "OXFORD HEALTH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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