Individual
DMITRY BLUMENKRANTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8075 N SHADELAND AVE STE AND310, INDIANAPOLIS, IN 46250
(317) 621-8500
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-9312
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01075467A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
01075467A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
266180B89
TRAD MEDICARE
IN
05
—
300016649
—
IN
01
—
P02085722
RAILROAD MEDICARE
IN
Enumeration date
04/06/2011
Last updated
06/11/2021
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