Individual
MARTIN D BLIDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
150 MUNDY STREET, MAC II BLDG, WILKES BARRE, PA 18702
(570) 824-7117
(570) 825-7610
Mailing address
610 WYOMING AVE, KINGSTON, PA 18704-3702
(570) 288-5441
(570) 288-5842
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD038941L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0042762000
INDEPENDENCE BS
PA
05
—
0802107
—
PA
01
—
802060
FIRST PRIORITY
PA
Enumeration date
12/14/2006
Last updated
08/14/2020
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