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Individual

MICHAEL BLANKINSHIP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4450 31ST AVE S STE 102, FARGO, ND 58104-4557
(701) 280-2033
(701) 232-5578
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-3300
(701) 364-8906

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
12697
ND
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
18176
ND
Enumeration date
04/03/2009
Last updated
04/03/2024
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