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Corey M Blum

Internal Medicine

Allopathic & Osteopathic Physicians

11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701

PECOS Enrollment

This provider is enrolled in PECOS as COREY BLUM.

Based on the most recent information from CMS, provider Corey M Blum is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1558789685
Provider Type
Individual
Full Name
Blum, Corey M
Gender
Male

Sole Proprietor
No
Enumeration Date
4/5/2014
Last Updated
10/10/2022

Contact Information

Practice Location

11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701

(260) 672-6620

(260) 672-6639

Mailing Location

11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 02005054A Indiana

Corey M Blum

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Thakur, Anayet Uddin

Byers, Rositsa I

Moningi, Venkata S

Prasad, Apurwa

Richardville, Jacob

Harvey, Lawrence

Auriti, Amber

Durrani, Mehnoor

Bhandari, Birat

Bui, Thi