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Individual

STEPHEN MICHAEL BLUM

Active
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Individual

STEPHEN MICHAEL BLUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
036077134
IL
2085R0202X
Diagnostic Radiology Physician
Primary
0036077134
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00598870
NY
05
036077134
IL
05
1451169
LA
01
1861441560
TRICARE NORTH
05
235428
AZ
05
2749477
OH
05
402417601
MD
05
402417602
MD
05
808256100
ID
05
8529588
WA
01
P00922031
RAILROAD MCR
OR
Enumeration date
05/09/2006
Last updated
03/07/2023
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