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NPI Code Detail

MEDICARE: DR. CARL ERNST BLUNCK M.D.

MEDICARE: DR. CARL ERNST BLUNCK M.D.
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
12085R0202XDiagnostic Radiology PhysicianME55224FL
22085R0202XDiagnostic Radiology Physician00012036AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689646473
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARL ERNST BLUNCK M.D.
Provider Business Mailing Address
First Line : 2055 NORMANDIE DR
Second Line : 108
City : MONTGOMERY
State : AL
Zip : 36111-2732
Country : US
Telephone Number : 334-288-4624
Fax Number : 334-280-3628
Provider Business Practice Location Address
First Line : 300 W OTTLEY AVE
Second Line :
City : FRUITA
State : CO
Zip : 81521-2118
Country : US
Telephone Number : 970-858-2186
Fax Number : 970-858-2208
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2006
Last Update Date : 06/26/2024

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