Individual
RANDALL RICHARD BLOUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
8372
SC
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
8372
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
083723
—
SC
01
—
1385497
CIGNA
SC
01
—
4304559
AETNA
SC
01
—
57-6007863037
BLUE CHOICE OF SC
SC
01
—
57-6007863080
BCBS OF SC
SC
Enumeration date
05/08/2006
Last updated
07/24/2013
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