Robert J Blommer, MD
Individual provider Active NPI Internal Medicine Physician · Ottumwa, IA
NPI 1770569717 · NPPES record last updated Oct 15, 2018
Key facts
- NPI
- 1770569717
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD-20241 (IA)
- Practice address
- 522 N Hancock St
Ottumwa, IA 52501-4231 - Phone
- (641) 683-0800
- Fax
- (641) 683-0801
- NPI assigned
- Dec 21, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20241 | IA | MD | Pharmacist |
| MD-20241 | IA | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD-20241 | IA | Yes |
Addresses
Primary practice location
522 N Hancock St
Ottumwa, IA 52501-4231
Mailing address
PO Box 1475
Des Moines, IA 50305-1475
Phone (641) 683-0800
Other practice location 1
522 N Hancock St
Ottumwa, IA 52501
Phone (641) 682-4594
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770569717 | Medicaid | IA |
Other providers in Ottumwa, IA
- Wendy Sue Bittner
- Dallas Black
- Megan R. Blaine
- Paige Blazina
- Stanley A Blew
- Bloom Pediatrics of Southern Iowa PLLC
- Brynn Kathryn Boche
- Maxwell Jon Bodholdt
- McKenna Jo Bond
- Jeff Bowley
All providers in Ottumwa, IA · Internal Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.