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NPI Code Detail

MEDICARE: DR. KENNETH ALAN BLANK M.D.

MEDICARE: DR. KENNETH ALAN BLANK M.D.
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
1207VG0400XGynecology Physician14263DC

General Provider Information

NPI Number : 1093739039
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENNETH ALAN BLANK M.D.
Provider Business Mailing Address
First Line : 8110 MAPLE LAWN BLVD STE 235
Second Line :
City : FULTON
State : MD
Zip : 20759-2694
Country : US
Telephone Number : 301-340-8339
Fax Number : 301-340-9027
Provider Business Practice Location Address
First Line : 2120 L ST NW STE 700
Second Line :
City : WASHINGTON
State : DC
Zip : 20037-1543
Country : US
Telephone Number : 202-331-9293
Fax Number : 410-584-1739
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 09/15/2023

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