Individual
GREGORY J BLYTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1026 A AVE NE, CEDAR RAPIDS, IA 52402-5036
(319) 431-8450
(319) 369-7419
Mailing address
1026 A AVE NE, CEDAR RAPIDS, IA 52402-5036
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DO-05171
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000835632
ANTHEM PIN
IN
05
—
201101120
—
IN
Enumeration date
05/02/2012
Last updated
04/27/2018
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