Individual
RICHARD LESTER BLANCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 521-2200
Mailing address
22 DELLWOOD CT, COCKEYSVILLE, MD 21030-1426
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C04872
MD
Other
Enumeration date
09/27/2012
Last updated
10/17/2012
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