MEDICARE: KEITH S BLUM DO PC

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	207T00000X	Neurological Surgery Physician

General Provider Information

NPI Number	:	1730373010
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEITH S BLUM DO PC

Provider Business Mailing Address
First Line	:	7271 W SAHARA AVE STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2862
Country	:	US
Telephone Number	:	702-240-4090
Fax Number	:	702-240-4091

Provider Business Practice Location Address
First Line	:	7271 W SAHARA AVE STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2862
Country	:	US
Telephone Number	:	702-240-4090
Fax Number	:	702-240-4091

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KEITH S BLUM
Credential	:	D.O.
Telephone Number	:	702-240-4091

Provider Enumeration Date	:	08/30/2007
Last Update Date	:	02/14/2020

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