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Individual

LARRY WEBSTER BLUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
203 HOSPITAL DR STE 200, GLEN BURNIE, MD 21061-6905
(410) 553-8160
(410) 553-8159
Mailing address
PO BOX 64584, BALTIMORE, MD 21264-4584

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
D37246
MD
2084N0600X
Clinical Neurophysiology Physician
D37246
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
165767
GROUP MEDICARE BWMC SURGICAL ASSOCIATES
MD
05
548571100
MD
Enumeration date
10/14/2005
Last updated
01/29/2020
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