Individual
DR. MIRIAM ALLISON BLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
801 7TH AVE, FORT WORTH, TX 76104-2733
(682) 885-1475
(682) 885-7520
Mailing address
PO BOX 99371, FORT WORTH, TX 76199-0371
(682) 885-1855
(682) 885-7347
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
P3857
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121521945A
—
GA
Enumeration date
05/03/2007
Last updated
08/01/2013
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