SearchIdaho363AS0400X

Mitchell Blume, PA-C, RD, CDE

NPI 1710334248 · on the registry since 2016

Practice

Address
190 E Bannock St
Boise, ID 83712
Phone
(208) 381-5015
Organisation at this address
St. Lukes
Picu Associates, Llc
St. Luke'S Children'S
St. Luke'S Health System
Boise Pathology Group P.A.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
695

Additional practice sites

  • 750 N Syringa St Ste 205, Post Falls, ID

Registry record

Primary taxonomy
363AS0400X
363AS0400X
Also registered as
363AS0400X
363AS0400X
Licence states on file
ID, WA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2022-06-30

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho