Individual
DR. DAVID MICHAEL BLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 325-2851
Mailing address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 325-2851
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G83637
CA
207LP3000X
Pediatric Anesthesiology Physician
4301093576
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G836370
BLUE SHIELD ID #
CA
05
—
00G836370
—
CA
01
—
00G836370385
CALOPTIMA ID #
CA
01
—
050077800
RAILROAD MEDICARE ID #
CA
Enumeration date
10/20/2006
Last updated
06/16/2011
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