Blouin, Randall Richard

Blouin, Randall Richard is an individual health care provider with primary practice located at 200 Patewood Dr Suite A350, Greenville SC 29615-3593. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities. Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities is his primary health care specialty. Blouin, Randall Richard can be contacted via phone (864) 454-5110.

Contact Information

Primary practice address
200 Patewood Dr Suite A350 Greenville SC 29615-3593
Phone: (864) 454-5110
Fax: (864) 454-5141
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 8372 South Carolina
Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities 2080P0008X 8372 South Carolina

Profile Details

NPI number 1366491342
LBN Legal business name Blouin, Randall Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2006
Last updated Jul 24th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366491342 NPPES
South Carolina Other 4304559 AETNA
South Carolina Other 57-6007863080 AETNA
South Carolina MEDICAID 083723 AETNA
South Carolina Other 57-6007863037 AETNA
South Carolina Other 1385497 AETNA

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