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Individual

IRA B BLANK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1301 POWELL ST, NORRISTOWN, PA 19401-3323
(610) 270-2717
(610) 270-2675
Mailing address
PO BOX 820137, PHILADELPHIA, PA 19182-0137
(610) 270-2352
(610) 270-2358

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD026563L
PA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD026563L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0046559000
IBC - PC, KHPE
PA
01
0071056001
AMERICHOICE(UHC)
PA
01
014338
HIGHMARK BLUE SHIELD
PA
01
1072341
KEYSTONE MERCY
PA
01
2559705
AETNA HMO
PA
01
350649
PHCS
PA
01
4642402
AETNA PPO
PA
01
7222159
CIGNA HMO/PPO
PA
01
MD26563L
HEALTH PARTNERS
PA
Enumeration date
01/17/2006
Last updated
09/11/2025
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