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Individual

DR. STUART LOUIS BLUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1811 E BERT KOUN LOOP, SUITE 110, SHREVEPORT, LA 71105-5740
(318) 212-3858
(318) 212-3958
Mailing address
1811 E BERT KOUN LOOP, SUITE 110, SHREVEPORT, LA 71105-5740
(318) 212-3858
(318) 212-3958

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
07432R
LA
207RC0000X
Cardiovascular Disease Physician
Primary
MD.07432R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1389749
LA
Enumeration date
09/21/2005
Last updated
08/18/2015
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