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General NPI Number Information
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NPI Number | 1003700717
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Entity Type | Organization
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Legal Business Name | BLUEMED LLC
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Dates
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Enumeration Date | 06/06/2025
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 467 LIGHTHOUSE TRL
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City | DAYTON
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State | OH
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Zip | 45458-3643
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Country | US
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Telephone | 571-225-8881
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Fax | 937-534-0166
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Provider Business Mailing Address
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Address Line | 467 LIGHTHOUSE TRL
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City | DAYTON
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State | OH
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Zip | 45458-3643
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Country | US
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Telephone | 571-225-8881
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Fax | 937-534-0166
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Authorized Official
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Title or Position | PRESIDENT
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Name | EHSAN SHABBIR
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Credential | MD
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Telephone | 571-225-8881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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