ZACHARY HARTLEY-BLOSSOM MD NPI 1225567902

NPI Information

NPI: 1225567902
Provider Name: ZACHARY HARTLEY-BLOSSOM, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
3264 N EVERGREEN DR NE
GRAND RAPIDS, MI
ZIP 49525
Phone: (616) 363-7272
Get Directions

Zachary Hartley-blossom, MD is a diagnostic radiology radiology in Grand Rapids, MI with 7 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Zachary Hartley-blossom, MD NPI is 1225567902. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: OAKLAND UNIV, WILLIAM BEAUMONT SCHOOL OF MEDICINE
Graduation Year:2017

The provider's business location address is:

3264 N EVERGREEN DR NE
GRAND RAPIDS, MI
ZIP 49525-746
Phone: (616) 363-7272
Fax: (616) 361-5828

The NPI 1225567902 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/7/2017 and was last updated on 12/18/2023.

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	2085R0202X	Radiology	Diagnostic Radiology	MD17244	RHODE ISLAND	No
2	2085R0202X	Radiology	Diagnostic Radiology	290918	MASSACHUSETTS	No
3	208600000X	Surgery		LP04037	RHODE ISLAND	No
4	2085R0202X	Radiology	Diagnostic Radiology	4301508654	MICHIGAN	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	MD17244	OTHER	RHODE ISLAND	RI MD LICENSE

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »