MEDICARE: DR. ADINA M. BLUM & ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OH5290	OH

General Provider Information

NPI Number	:	1205153160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. ADINA M. BLUM & ASSOCIATES

Provider Business Mailing Address
First Line	:	4012 EASTON STATION
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219
Country	:	US
Telephone Number	:	614-476-2586
Fax Number	:	614-478-1862

Provider Business Practice Location Address
First Line	:	4012 EASTON STATION
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219
Country	:	US
Telephone Number	:	614-476-2586
Fax Number	:	614-478-1862

Authorized Official
Title or Position	:	OPTOMETRIST/OWNER
Name	:	DR. ADINA MICHELE BLUM
Credential	:	O.D.
Telephone Number	:	614-476-2586

Provider Enumeration Date	:	04/30/2010
Last Update Date	:	07/27/2010

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