Individual
JOHN DAVID BLEVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 936-7372
(803) 936-4102
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 936-7372
(803) 936-4102
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
058855
GA
2084N0400X
Neurology Physician
Primary
86721
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7108788
—
VA
Enumeration date
01/27/2006
Last updated
04/19/2023
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