Individual
JAMES LEE BLUMLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2800 FERRY ST, LAFAYETTE, IN 47904-3022
(765) 448-8000
(765) 447-9749
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01033555A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000184484
ANTHEM PROVIDER NUMBER
IN
05
—
100203670
—
IN
01
—
10824803
CAQH NUMBER
IN
01
—
408548
PHCS PID NUMBER
IN
Enumeration date
03/14/2006
Last updated
07/23/2012
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