Individual
DR. MIRAN JOEL BLANCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
820 4TH ST N, FARGO, ND 58102-4539
(701) 234-6161
Mailing address
820 4TH ST N, FARGO, ND 58102-4539
(701) 234-6161
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
105542
MN
2085R0001X
Radiation Oncology Physician
Primary
13647
ND
2085R0001X
Radiation Oncology Physician
54356
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
ND
Other
Enumeration date
04/21/2011
Last updated
03/25/2022
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