MEDICARE: MELVIN BLANEY

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	1223G0001X	General Practice Dentistry	9215	MD

General Provider Information

NPI Number	:	1780733030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELVIN BLANEY

Provider Business Mailing Address
First Line	:	2426 W COLD SPRING LN
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-6915
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3435 BOX HILL CORPORATE CENTER DR
Second Line	:
City	:	ABINGDON
State	:	MD
Zip	:	21009-1204
Country	:	US
Telephone Number	:	410-569-6299
Fax Number	:

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

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	07/08/2007

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Directions to “ MELVIN BLANEY ” Practice Location

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