Blouin, Randall Richard
Blouin, Randall Richard is an individual health care provider with primary practice located at 200 Patewood Dr Suite A350, Greenville SC 29615-3593. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities. Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities is his primary health care specialty. Blouin, Randall Richard can be contacted via phone (864) 454-5110.Contact Information
Primary practice address
200 Patewood Dr Suite A350
Greenville SC 29615-3593
Phone: (864) 454-5110
Fax: (864) 454-5141
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 8372 | South Carolina |
| Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities | 2080P0008X | 8372 | South Carolina |
Profile Details
| NPI number | 1366491342 |
|---|---|
| LBN Legal business name | Blouin, Randall Richard |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 8th, 2006 |
| Last updated | Jul 24th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366491342 | NPPES |
| South Carolina | Other | 4304559 | AETNA |
| South Carolina | Other | 57-6007863080 | AETNA |
| South Carolina | MEDICAID | 083723 | AETNA |
| South Carolina | Other | 57-6007863037 | AETNA |
| South Carolina | Other | 1385497 | AETNA |
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