Individual
STEVEN BLUMENTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
180 PARK AVE, PORTLAND, ME 04102-2927
(207) 772-3703
(207) 773-1177
Mailing address
75 JOHN ROBERTS RD BLDG B, SOUTH PORTLAND, ME 04106-6967
(207) 775-4151
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
012914
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
296060099
—
ME
Enumeration date
07/07/2006
Last updated
07/18/2023
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