Blume, Mitchell Eric

Blume, Mitchell Eric is an individual health care provider with primary practice located at 190 E Bannock St , Boise ID 83712-6241. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Blume, Mitchell Eric can be contacted via phone (208) 381-5015.

Contact Information

Primary practice address
190 E Bannock St Boise ID 83712-6241
Phone: (208) 381-5015
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA-1517 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA60794259 Washington
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA-2266 Idaho

Profile Details

NPI number 1710334248
LBN Legal business name Blume, Mitchell Eric
Credentials PA-C, RD, CDE
Entity Individual
Sole proprietor 1 No
Enumeration date May 13th, 2016
Last updated Jun 30th, 2022 - about 3 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 1710334248 NPPES
Idaho MEDICAID 1710334248

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