MEDICARE: JOHN BLANNETT 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
1	207RC0000X	Cardiovascular Disease Physician	MD019872E	PA

Other Identifiers

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

General Provider Information

NPI Number	:	1780689794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN BLANNETT MD

Provider Business Mailing Address
First Line	:	1503 LANSDOWNE AVE
Second Line	:	STE 3001
City	:	DARBY
State	:	PA
Zip	:	19023-1330
Country	:	US
Telephone Number	:	610-586-4100
Fax Number	:	610-586-4114

Provider Business Practice Location Address
First Line	:	1503 LANSDOWNE AVE
Second Line	:	STE 3001
City	:	DARBY
State	:	PA
Zip	:	19023-1330
Country	:	US
Telephone Number	:	610-586-4100
Fax Number	:	610-586-4114

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/09/2007

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Directions to “ JOHN BLANNETT MD” Practice Location

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