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Individual

DAVID T. BLANK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
8111 S EMERSON AVE, INDIANAPOLIS, IN 46237-8601
(317) 528-5261
(317) 528-5026
Mailing address
PO BOX 7112, DEPT. #31, INDIANAPOLIS, IN 46207-7112
(317) 802-3151
(317) 870-0499

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02001351
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200106840
IN
Enumeration date
08/12/2006
Last updated
09/09/2015
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