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Mitchell Blume, PA-C, RD, CDE — NPI 1710334248, Boise, ID | NPI Central

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NPI 1710334248

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Mitchell Blume, PA-C, RD, CDE

NPI 1710334248 · Surgical Physician Assistant · Boise, ID

Provider details

NPI number: 1710334248
Entity type: Individual
Primary specialty: Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Credential: PA-C, RD, CDE
Sex: Male
Sole proprietor: No
License: PA-1517 (ID)

Specialties & taxonomies

Surgical Physician AssistantPrimary363AS0400XLicense PA-2266 (ID)
Physician Assistants & Advanced Practice Nursing Providers
Surgical Physician Assistant363AS0400XLicense PA-1517 (ID)
Physician Assistants & Advanced Practice Nursing Providers
Surgical Physician Assistant363AS0400XLicense PA60794259 (WA)
Physician Assistants & Advanced Practice Nursing Providers

Practice location

190 E Bannock St

Boise, ID 83712-6241

Phone: (208) 381-5015

Approximate (ZIP-level) locationGet directions

More ID providers

Mailing address

190 E Bannock St

Boise, ID 83712-6241

Additional practice locations (1)

750 N Syringa St Ste 205
Post Falls, ID 83854-5275
Phone: (208) 262-0945
Fax: (208) 415-0150

Registry dates

Enumerated: 2016-05-13
Last updated: 2022-06-30
Certified: 2022-06-30

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.