Blumenthal, Kenneth Wayne

Blumenthal, Kenneth Wayne is an individual health care provider with primary practice located at 2802 Leonard Dr , Valparaiso IN 46383-7136. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Blumenthal, Kenneth Wayne can be contacted via phone (219) 531-5855.

Contact Information

Primary practice address
2802 Leonard Dr Valparaiso IN 46383-7136
Fax: (219) 531-1617
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02000639 Indiana

Profile Details

NPI number 1427053255
LBN Legal business name Blumenthal, Kenneth Wayne
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated May 8th, 2024 - about 6 months 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 1427053255 NPPES
Indiana Other 080152596 RAILROAD MEDICARE
Indiana MEDICAID 100352990 RAILROAD MEDICARE
Indiana Other 000000093874 RAILROAD MEDICARE

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