Individual
BRUCE GARY BLANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
92 N 4TH ST, SUITE 27, MARTINS FERRY, OH 43935-1691
(740) 633-4188
(740) 633-4716
Mailing address
92 N 4TH ST, SUITE 27, MARTINS FERRY, OH 43935-1691
(740) 633-4188
(740) 633-4716
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
00239
WV
213E00000X
Podiatrist
Primary
36002569
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000141557
ANTHEM BCBC
OH
05
—
0099535000
—
WV
05
—
01548623
—
PA
05
—
0747213
—
OH
01
—
2102991
MAMSI
—
01
—
2569
HEALTH PLAN
OH
01
—
4295099
AETNA
—
01
—
480027937
RAILROAD MEDICARE
—
01
—
6491296002
CIGNA
—
Enumeration date
02/06/2006
Last updated
03/19/2014
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