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Individual

ANDREW S BLUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, PHD

Contact information

Practice address
593 EDDY ST, APC-5, PROVIDENCE, RI 02903-4923
(401) 444-3032
(401) 444-3205
Mailing address
15 LA SALLE SQ, PROVIDENCE, RI 02903-1814
(401) 444-6779
(401) 444-6912

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD10439
RI
2084N0600X
Clinical Neurophysiology Physician
MD10439
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1376579318
RI
Enumeration date
06/23/2006
Last updated
12/18/2025
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