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General NPI Number Information
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NPI Number | 1538091061
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Entity Type | Organization
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Legal Business Name | CRAIG BLUM PC
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Dates
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Enumeration Date | 06/01/2026
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Last Update Date | 06/01/2026
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Provider Practice Location Address
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Address Line | 218 BRIGHTON PARK BLVD STE 101
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City | SUMMERVILLE
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State | SC
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Zip | 29486-3013
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Country | US
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Telephone | 843-471-1135
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Fax |
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Provider Business Mailing Address
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Address Line | 218 BRIGHTON PARK BLVD STE 101
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City | SUMMERVILLE
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State | SC
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Zip | 29486-3013
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Country | US
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Telephone | 843-471-1135
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CRAIG BLUM
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Credential | MD
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Telephone | 843-818-8747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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