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NPI Code Detail

MEDICARE: AMY ELIZABETH BLUM

MEDICARE:   AMY ELIZABETH BLUM
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
1225X00000XOccupational Therapist09307MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
109307OTHERMDSTATE DEPARTMENT OF HEALTH

General Provider Information

NPI Number : 1639741762
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY ELIZABETH BLUM
Provider Business Mailing Address
First Line : PO BOX 500
Second Line :
City : BROOKEVILLE
State : MD
Zip : 20833-0500
Country : US
Telephone Number : 301-498-8100
Fax Number : 301-498-0009
Provider Business Practice Location Address
First Line : 5500 KNOLL NORTH DR STE 150
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-2476
Country : US
Telephone Number : 443-542-0062
Fax Number : 443-542-0250
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2021
Last Update Date : 02/01/2023

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