MEDICARE: DAVID M. BLOMERT 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	207Q00000X	Family Medicine Physician	040870	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316022627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID M. BLOMERT M.D.

Provider Business Mailing Address
First Line	:	601 S. ENOTA DRIVE
Second Line	:	STE. Q
City	:	GAINESVILLE
State	:	GA
Zip	:	30501
Country	:	US
Telephone Number	:	770-533-8406
Fax Number	:	770-533-8409

Provider Business Practice Location Address
First Line	:	1292 ATHENS ST
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30507-7000
Country	:	US
Telephone Number	:	770-531-5654
Fax Number	:	770-532-5341

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

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	02/19/2010

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Directions to “ DAVID M. BLOMERT M.D.” Practice Location

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