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NPI Code Detail

MEDICARE: DR. MICHAEL S BLANK MD

MEDICARE: DR. MICHAEL S BLANK MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RI0200XInfectious Disease Physician35-08-6360OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710926985
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL S BLANK MD
Provider Business Mailing Address
First Line : 1031 PIERCE STREET
Second Line : SUITE D
City : SANDUSKY
State : OH
Zip : 44870
Country : US
Telephone Number : 419-557-5541
Fax Number : 419-557-5542
Provider Business Practice Location Address
First Line : 1912 HAYES AVE
Second Line :
City : SANDUSKY
State : OH
Zip : 44870-4736
Country : US
Telephone Number : 419-557-6780
Fax Number : 419-557-6783
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2006
Last Update Date : 09/11/2012

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