MITCHELL ERIC BLUME PA-C RD CDE NPI 1710334248

NPI Information

NPI: 1710334248
Provider Name: MITCHELL ERIC BLUME, PA-C, RD, CDE
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Organization: UNIVERSITY OF UTAH ADULT SERVICES

PECOS Registration: Yes

Address:
750 N SYRINGA ST STE 205
POST FALLS, ID
ZIP 83854
Phone: (208) 262-0945
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Mitchell Eric Blume, PA-C, RD, CDE is a surgical physician assistant in Post Falls, ID with 7 years of experience. Mitchell Eric Blume, PA-C, RD, CDE NPI is 1710334248. 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:

750 N SYRINGA ST STE 205
POST FALLS, ID
ZIP 83854-275
Phone: (208) 262-0945
Fax: (208) 415-0150

The NPI 1710334248 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 5/13/2016 and was last updated on 10/28/2021.

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	363AS0400X	Physician Assistant	Surgical	PA60794259	WASHINGTON	No
2	363AS0400X	Physician Assistant	Surgical	PA-1517	IDAHO	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	1710334248	MEDICAID	IDAHO

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: 11/14/2023

NPI Synchronization or Removal

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