Provider Demographics
NPI:1598833436
Name:BLUM, DONALD ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ALAN
Last Name:BLUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 E BENJAMIN DR
Mailing Address - Street 2:
Mailing Address - City:NEW MARTINSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26155-2705
Mailing Address - Country:US
Mailing Address - Phone:304-455-8082
Mailing Address - Fax:
Practice Address - Street 1:3 E BENJAMIN DR STE B
Practice Address - Street 2:
Practice Address - City:NEW MARTINSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26155-2705
Practice Address - Country:US
Practice Address - Phone:304-455-8082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVA71922207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
550573806OtherACORDIA
WV001719623OtherMOUNTAIN STATE BCBS
550573806OtherEMPLOYEE BENEFIT SERVICES
550573806OtherUNITEDHEALTHCARE
550573806OtherHUMANA GOLD
205249OtherCOVENTRY HEALTH & LIFE IN
550573806OtherBANKERS LIFE & CASUALTY C
55057380600OtherIRONWORKERS LOCAL 549 & 5
5505738060002OtherCIGNA
WV0052921000Medicaid
550573806OtherAETNA
WVI010140OtherHEALTH PLAN
550573806OtherTRICARE
550573806A01OtherMEDICAL MUTUAL
WV001719623OtherMOUNTAIN STATE BCBS
550573806OtherBANKERS LIFE & CASUALTY C