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General NPI Number Information
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NPI Number | 1386197283
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Entity Type | Organization
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Legal Business Name | DR. DOROTHY THOMAS-BLUME D.O.
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Dates
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Enumeration Date | 07/27/2016
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Last Update Date | 07/27/2016
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Provider Practice Location Address
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Address Line | 105 BURTON AVE
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City | SUMMERVILLE
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State | SC
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Zip | 29485-8118
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Country | US
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Telephone | 843-832-5379
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 JOHNNIE DODDS BLVD #2278
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-3684
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DOROTHY THOMAS-BLUME
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Credential | DO
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Telephone | 202-299-6536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 1635
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License Number State | SC
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