Individual
DAVID RICHARD BLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
501 COLLIERS WAY, WEIRTON, WV 26062-5003
(304) 723-5440
Mailing address
501 COLLIERS WAY, WEIRTON, WV 26062-5003
(304) 723-5440
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
464
WV
103TA0400X
Addiction (Substance Use Disorder) Psychologist
464
WV
103TC0700X
Clinical Psychologist
Primary
464
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001719066
BCBS
WV
05
—
0165132000
—
WV
Enumeration date
12/08/2006
Last updated
01/25/2012
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