RANDALL RICHARD BLOUIN M.D. NPI 1366491342

NPI Information

NPI: 1366491342
Provider Name: RANDALL RICHARD BLOUIN, M.D.
Classification: Pediatrics - 2080P0008X
Entity Type: Individual

Specialization: Neurodevelopmental Disabilities

Address:
200 PATEWOOD DR
SUITE A350
GREENVILLE, SC
ZIP 29615
Phone: (864) 454-5110
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Randall Richard Blouin, M.D. is a neurodevelopmental disabilities pediatrics in Greenville, SC. The provider is a pediatrician who specializes in the treatment of individuals with developmental delays and learning disorders associated with cerebral palsy, spina bifida, autism, and other chronic neurologic conditions. Randall Richard Blouin, M.D. NPI is 1366491342. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

200 PATEWOOD DR
SUITE A350
GREENVILLE, SC
ZIP 29615-593
Phone: (864) 454-5110
Fax: (864) 454-5141

The enumeration date for this NPI number is 5/8/2006 and was last updated on 7/24/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		8372	SOUTH CAROLINA	No
2	2080P0008X	Pediatrics	Neurodevelopmental Disabilities	8372	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	D17477	MEDICARE UPIN	SOUTH CAROLINA
2	57-6007863080	OTHER	SOUTH CAROLINA	BCBS OF SC
3	D174777951	MEDICARE PIN	SOUTH CAROLINA
4	083723	MEDICAID	SOUTH CAROLINA
5	D174776904	MEDICARE PIN	SOUTH CAROLINA
6	57-6007863037	OTHER	SOUTH CAROLINA	BLUE CHOICE OF SC
7	4304559	OTHER	SOUTH CAROLINA	AETNA
8	1385497	OTHER	SOUTH CAROLINA	CIGNA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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