person
Kenneth Wayne Blumenthal, DO
Family Medicine Physician in Portage, Indiana
NPI 1427053255

Kenneth Wayne Blumenthal is a Family Medicine Physician based in Portage, IN. Kenneth Wayne Blumenthal practices in Portage, IN and has the professional credentials of DO. The NPI Number for Kenneth Wayne Blumenthal is 1427053255 and holds a License No. 02000639 (Indiana).

The current practice location address for Kenneth Wayne Blumenthal is 3125 Willowcreek Rd, Portage, IN and can be reached out via phone at 219-762-3175 and via fax at 219-763-3092. You can also correspond with Kenneth Wayne Blumenthal through the mailing address at 3125 WILLOWCREEK RD, PORTAGE, IN - 46368-4423 (mailing address contact number: 219-762-3175).

Location: 3125 Willowcreek Rd, Portage, IN, 46368-4423
person
Provider Profile Details
NPI Number
1427053255
Provider Name
Kenneth Wayne Blumenthal
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
3125 Willowcreek Rd, Portage, IN, 46368-4423
Phone Number
219-762-3175
Fax Number
219-763-3092
Provider Enumeration Date
06/17/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
080152596 01 IN RAILROAD MEDICARE
000000093874 01 IN AMTHEM BC/BS
100352990 05 IN
institution
Provider Business Practice Location Address Details
Address
3125 Willowcreek Rd
City
State
Zip
46368-4423
Phone Number
219-762-3175
Fax Number
219-763-3092
person
Provider Business Mailing Address Details
Address
3125 Willowcreek Rd
City
State
Zip
46368-4423
Phone Number
219-762-3175
Fax Number
219-763-3092
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
License No.
02000639 (Indiana)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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