Individual
KEVIN J BLANKENSHIP
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
63 WHARF ST, SUITE 100, MORGANTOWN, WV 26501-5937
(304) 291-3627
(304) 598-3630
Mailing address
63 WHARF ST, SUITE 100, MORGANTOWN, WV 26501-5937
(304) 291-3627
(304) 598-3630
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
19121
WV
207P00000X
Emergency Medicine Physician
C186856
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0047827000
—
WV
01
—
550783964002
MT STATE BCBS
WV
01
—
WV19121A
HEALTH PLAN
WV
Enumeration date
07/18/2005
Last updated
12/02/2025
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