Organization
BLOSSOMWOOD MEDICAL PC
Active
Organization
BLOSSOMWOOD MEDICAL PC
Active
Other names
Blossomwood Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VYTAUTAS PUKIS MD (PHYSICIAN)
(256) 431-9257
Entity
Organization
Contact information
Practice address
2121 WHITESBURG DR SE, SUITE C, HUNTSVILLE, AL 35801-4501
(256) 883-0107
(256) 883-0207
Mailing address
2121 WHITESBURG DR SE, SUITE C, HUNTSVILLE, AL 35801-4501
(256) 883-0107
(256) 883-0207
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD29689
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113285
—
AL
Enumeration date
08/05/2009
Last updated
02/04/2013
Update your record
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