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General NPI Number Information
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NPI Number | 1649296674
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Entity Type | Organization
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Legal Business Name | HAROLD L. BLUMENTHAL, M.D., INC.
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 11/05/2019
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Provider Practice Location Address
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Address Line | 3619 PARK EAST DR SUITE 209
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City | BEACHWOOD
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State | OH
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Zip | 44122-4330
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Country | US
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Telephone | 216-464-7200
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Fax | 216-464-0020
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Provider Business Mailing Address
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Address Line | 3619 PARK EAST DR SUITE 209
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City | BEACHWOOD
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State | OH
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Zip | 44122-4330
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Country | US
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Telephone | 216-464-7200
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Fax | 216-464-0020
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Authorized Official
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Title or Position | VPRES
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Name | DR. HAROLD BLUMENTHAL
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Credential | MD
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Telephone | 216-464-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 3502462613
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License Number State | OH
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