Individual
GREGORY MICHAEL BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5255 LOUGHBORO RD NW BLDG B, WASHINGTON, DC 20016-2633
(202) 537-4080
(202) 537-4588
Mailing address
6201 GREENLEIGH AVE # 655, MIDDLE RIVER, MD 21220-2004
(410) 933-2704
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD045667
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390200000X
—
NY
01
—
MD045667
STATE LICENSE
DC
Enumeration date
05/13/2010
Last updated
01/09/2024
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