Individual
CHERYL L BLANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
887 CONGRESS ST, SUITE 410B, PORTLAND, ME 04102-3100
(207) 662-5522
(207) 662-5527
Mailing address
301 US ROUTE 1, BUILDING C, SCARBOROUGH, ME 04074-7609
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
OS013295
PA
2080P0206X
Pediatric Gastroenterology Physician
Primary
2053
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101336885
—
PA
05
—
30226634
—
NH
05
—
432917499
—
ME
Enumeration date
02/03/2006
Last updated
03/10/2011
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