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
Update your record
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