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General NPI Number Information
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NPI Number | 1730539800
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Entity Type | Individual
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Provider Name | KEVIN MICHAEL BLUME D.O
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Gender | Male
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Dates
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Enumeration Date | 06/20/2016
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 395 N SILVERBELL RD STE 201
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City | TUCSON
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State | AZ
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Zip | 85745-2719
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Country | US
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Telephone | 520-792-2170
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Fax |
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Provider Business Mailing Address
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Address Line | 395 N SILVERBELL RD STE 201
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City | TUCSON
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State | AZ
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Zip | 85745-2719
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Country | US
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Telephone | 520-792-2170
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | 5101022462
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | 009086
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License Number State | AZ
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