Individual
ROBERT JOHN BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-8700
(920) 303-8993
Mailing address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-8700
(920) 303-8993
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
52680-020
WI
208D00000X
General Practice Physician
52680-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100075672
—
WI
Enumeration date
10/13/2009
Last updated
03/15/2024
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