Individual
MARTIN L BLANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE STR., 6 SILVERSTEIN, PHILADELPHIA, PA 19104
(215) 662-2050
Mailing address
3400 SPRUCE STR., 6 SILVERSTEIN, PHILADELPHIA, PA 19104
(215) 662-2050
(440) 879-0084
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD442522
PA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD442522
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000125631
ANTHEM
OH
Enumeration date
12/09/2005
Last updated
05/07/2014
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