Benjamin Martin Bly, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

4301094347 Issued in MI

Practice address

1500 East Medical Center Drive
1St Floor University Hospital Room 1B300
Ann Arbor, MI 48109-5036

Phone

(734) 936-9035

Fax

(734) 936-5520

NPI assigned

Jun 30, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381190400000",
    "number": "1023246998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 SOUTH STATE STREET",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 EAST MEDICAL CENTER DRIVE",
            "address_2": "1ST FLOOR UNIVERSITY HOSPITAL ROOM 1B300",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095036",
            "telephone_number": "734-936-9035",
            "fax_number": "734-936-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLY",
        "first_name": "BENJAMIN",
        "middle_name": "MARTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2013-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301094347",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301094347",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Scott Blum, P.T., DPT
• Kate Goldie Marie Blumenstein, MD
• Aubree Blumer
• Diane Blumson, LMSW
• Raymond Richard Blush III, ACNP
• Amber Bo, MD
• Andrew Boal, MD, PHD
• Brooke Boardman
• Kristen Ann Boardman, PA
• Sara Marie Bobak, MD

• Neurology Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Neurology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.