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Individual
BRAD D. BLANKENHORN
Active
Individual
BRAD D. BLANKENHORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2012-0546
NM
207X00000X
Orthopaedic Surgery Physician
Primary
MD13206
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110087299A
MASSHEALTH
RI
05
—
BB81009
—
RI
Enumeration date
04/19/2007
Last updated
02/14/2019
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