Blumberg, Mark A

Blumberg, Mark A is an individual health care provider with primary practice located at 3455 Main St Suite 5, Springfield MA 01107-1147. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Blumberg, Mark A can be contacted via phone (413) 733-9600.

Contact Information

Primary practice address
3455 Main St Suite 5 Springfield MA 01107-1147
Phone: (413) 733-9600
Fax: (413) 732-6534
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 223863 Massachusetts
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X 223863 Massachusetts

Profile Details

NPI number 1588662019
LBN Legal business name Blumberg, Mark A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2005
Last updated Nov 8th, 2007 - about 17 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 1588662019 NPPES
Other 223863 CONNECTICARE
Other J28609 CONNECTICARE
Other 36373 CONNECTICARE
Other 470305 CONNECTICARE
Other P00231584 CONNECTICARE

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