| Doctor Name: | DR. STUART LOUIS BLUM |
| NPI Number: | 1073509535 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 07432R |
| Business Practice Address: | 1811 E Bert Koun Loop Suite 110 Shreveport, LA - 711055740 |
| Business Phone Number: | 3182123858 |
| Business Fax Number: | 3182123958 |
| Mailing Address: | 1811 E Bert Koun Loop, Suite 110 SHREVEPORT |
| State: | LA |
| Postal Code: | 711055740 |
| Phone Number: | 3182123858 |
| Fax Number: | 3182123958 |
| NPI Enumeration Date: | 09/21/2005 |
| NPI Last Update Date: | 08/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 03/24/2006 |
| NPI Reactivation Date: | 04/04/2006 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 07432R |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | LA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |