Provider Demographics
NPI:1003700717
Name:BLUEMED LLC
Entity type:Organization
Organization Name:BLUEMED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EHSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHABBIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-225-8881
Mailing Address - Street 1:467 LIGHTHOUSE TRL
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-3643
Mailing Address - Country:US
Mailing Address - Phone:571-225-8881
Mailing Address - Fax:937-534-0166
Practice Address - Street 1:467 LIGHTHOUSE TRL
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-3643
Practice Address - Country:US
Practice Address - Phone:571-225-8881
Practice Address - Fax:937-534-0166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty