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1245207315

NPI Code Detail

MEDICARE: DR. JOHN R BLUMER M.D.

MEDICARE: DR. JOHN R BLUMER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	35841	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11317	OTHER	NC	DOCTORS HEALTH PLAN
2	141024	OTHER		COVENTRY HEALTHCARE HMO
3	16393	OTHER	NC	BCBS
4	9466	OTHER		PARTNERS SELECT CARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	01146087	OTHER	SC	AMERIGROUP COMMUNITY CARE
7	20087248	OTHER	SC	SELECT HEALTH OF SC/FIRST CHOICE
8	4570715	OTHER		AETNA
9	276567	OTHER		MAMSI
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	44672	OTHER	NC	MEDCOST
12	26674	OTHER	NC	WELLPATH
13	771567	OTHER	SC	WELLCARE
14	5703439003	OTHER	NC	CIGNA

General Provider Information

NPI Number	:	1245207315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN R BLUMER M.D.

Provider Business Mailing Address
First Line	:	6035 FAIRVIEW RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-3256
Country	:	US
Telephone Number	:	704-295-3000
Fax Number	:	704-838-8494

Provider Business Practice Location Address
First Line	:	6035 FAIRVIEW RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-3256
Country	:	US
Telephone Number	:	704-295-3000
Fax Number	:	704-838-8494

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	03/31/2021

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Directions to “ DR. JOHN R BLUMER M.D.” Practice Location

Language	Start Address	Practice Location

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