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General NPI Number Information
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NPI Number | 1225142060
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Entity Type | Organization
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Legal Business Name | M. BARRY BLUM MD PA
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2 HAMILL RD SUITE 215
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City | BALTIMORE
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State | MD
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Zip | 21210-1806
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Country | US
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Telephone | 410-486-3736
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Fax | 410-486-3737
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Provider Business Mailing Address
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Address Line | 2 HAMILL RD SUITE 215
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City | BALTIMORE
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State | MD
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Zip | 21210-1806
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Country | US
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Telephone | 410-486-3736
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Fax | 410-486-3737
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Authorized Official
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Title or Position | OPHTHALMOLOGIST
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Name | MYRON BARRY BLUM
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Credential | MD
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Telephone | 410-486-3736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD000569
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License Number State | MD
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