Individual
STANLEY A BLEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1005 PENNSYLVANIA AVE, SUITE 104, OTTUMWA, IA 52501-6408
(641) 682-4594
(641) 682-2123
Mailing address
PO BOX 1475, DES MOINES, IA 50305-1475
(641) 682-4594
(641) 682-2123
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21477
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0020743
—
IA
05
—
0215376
—
IA
05
—
1020743
—
IA
05
—
1093791030
—
IA
01
—
110144452
RR MEDICARE
IA
Enumeration date
12/21/2005
Last updated
07/17/2013
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