Provider Demographics
NPI:1306126040
Name:BLONDHEIM, JAMES POLLACK (PD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:POLLACK
Last Name:BLONDHEIM
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 YORK RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-2636
Mailing Address - Country:US
Mailing Address - Phone:443-524-4535
Mailing Address - Fax:443-524-4531
Practice Address - Street 1:6301 YORK RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-2636
Practice Address - Country:US
Practice Address - Phone:443-524-4535
Practice Address - Fax:443-524-4531
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08556183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist