Individual
MICHAEL LLOYD BLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11104 PARKVIEW CIRCLE DR STE 310, FORT WAYNE, IN 46845-1733
(260) 266-5230
(260) 266-5238
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
01083133A
IN
207RG0100X
Gastroenterology Physician
52634
KY
207RG0100X
Gastroenterology Physician
Primary
ME52969
FL
Other
Enumeration date
09/26/2005
Last updated
12/15/2021
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