Individual
BRUCE BLUMENTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1860 REISTERSTOWN RD, PIKESVILLE, MD 21208-1335
(410) 415-5105
Mailing address
1860 REISTERSTOWN RD, PIKESVILLE, MD 21208-1335
(410) 415-5105
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0024242
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008203100
—
MD
01
—
0101480
EVERCARE
—
01
—
093NER-352102-02
CAREFIRST BCBS OF MD
—
01
—
093NSE-352102-02
CAREFIRST BCBS OF MD
—
01
—
0943ER-352102-04
CAREFIRST BCBS OF MD
—
05
—
318541900
—
MD
01
—
35210202
BCBS OF MD
MD
01
—
522096682001
TRICARE
MD
01
—
9676-0004
CAREFIRST BCBS OF DC
—
01
—
T106-0038
BCBS-DC
—
Enumeration date
03/15/2006
Last updated
02/07/2019
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