MEDICARE: DR. STEVEN JOHN BLUMHOF D.O.

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	207Q00000X	Family Medicine Physician	34.002129	OH

General Provider Information

NPI Number	:	1265446447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN JOHN BLUMHOF D.O.

Provider Business Mailing Address
First Line	:	5656 STONE LAKE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45429-6001
Country	:	US
Telephone Number	:	937-435-0934
Fax Number	:

Provider Business Practice Location Address
First Line	:	5656 STONE LAKE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45429-6001
Country	:	US
Telephone Number	:	937-435-0934
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/08/2007

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