MEDICARE: DR. MARTIN BLUME D.O. MBA

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	1641	AZ

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	:	1760486310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN BLUME D.O. MBA

Provider Business Mailing Address
First Line	:	8575 E PRINCESS DR
Second Line	:	SUITE 111
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-5483
Country	:	US
Telephone Number	:	480-699-7999
Fax Number	:	480-247-7580

Provider Business Practice Location Address
First Line	:	8575 E PRINCESS DR
Second Line	:	SUITE 111
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-5483
Country	:	US
Telephone Number	:	480-699-7999
Fax Number	:	480-247-7580

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

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	03/06/2012

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