Individual
DR. PAUL S BLUNDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
29751 LITTLE MACK AVE, SUITE B, ROSEVILLE, MI 48066-2238
(586) 415-6200
(586) 415-6217
Mailing address
86 WILLOW TREE PL, GROSSE POINTE SHORES, MI 48236-1322
(586) 415-6200
(586) 415-6217
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
406742
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E061676161
MEDICARE PROVIDER ID
MI
05
—
2641140
—
MI
Enumeration date
07/27/2005
Last updated
02/16/2010
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