Individual
JOHN E BLOMSTEDT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2 W 42ND ST STE 3500, SCOTTSBLUFF, NE 69361-4669
(308) 630-2595
(308) 630-2596
Mailing address
2 W 42ND ST STE 3500, SCOTTSBLUFF, NE 69361-4669
(308) 630-2595
(308) 630-2596
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
724
NE
207Q00000X
Family Medicine Physician
724
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200913070
—
IN
Enumeration date
04/10/2007
Last updated
03/28/2018
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