Healthcare Provider Details

I. General information

NPI: 1447318902
Provider Name (Legal Business Name): TERRI L BLUME PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2411 W BELVEDERE AVE SUITE 402
BALTIMORE MD
21215-5228
US

IV. Provider business mailing address

2411 W BELVEDERE AVE SUITE 402
BALTIMORE MD
21215-5228
US

V. Phone/Fax

Practice location:
  • Phone: 410-601-8314
  • Fax: 410-601-9974
Mailing address:
  • Phone: 410-601-8314
  • Fax: 410-601-9974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberC0001535
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: