Provider Demographics
NPI:1447318902
Name:BLUME, TERRI L (PA-C)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:L
Last Name:BLUME
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 W BELVEDERE AVE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5228
Mailing Address - Country:US
Mailing Address - Phone:410-601-8314
Mailing Address - Fax:410-601-9974
Practice Address - Street 1:2411 W BELVEDERE AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5228
Practice Address - Country:US
Practice Address - Phone:410-601-8314
Practice Address - Fax:410-601-9974
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0001535208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine