Individual
DINA CHRISTINA BLOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1508 6TH AVE, HUNTINGTON, WV 25701-2902
(304) 522-8311
(304) 522-8313
Mailing address
PO BOX 366, HUNTINGTON, WV 25708-0366
(304) 522-8311
(304) 522-8313
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
21513
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1810976000
—
WV
05
—
2502134
—
OH
Enumeration date
03/08/2006
Last updated
01/25/2012
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