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NPI Code Detail

MEDICARE: CHRISTIE BEAN BLANTON MD

MEDICARE:   CHRISTIE BEAN BLANTON  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
1207RG0100XGastroenterology PhysicianMD.204373LA
2207RG0100XGastroenterology PhysicianCDRH.0065507CO
3207RG0100XGastroenterology Physician76444AZ
4207RG0100XGastroenterology Physician72305TN

General Provider Information

NPI Number : 1780818286
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIE BEAN BLANTON MD
Provider Business Mailing Address
First Line : 2750 BROADWAY ST
Second Line :
City : BOULDER
State : CO
Zip : 80304-3586
Country : US
Telephone Number : 303-440-3216
Fax Number : 303-440-3209
Provider Business Practice Location Address
First Line : 2750 BROADWAY ST
Second Line :
City : BOULDER
State : CO
Zip : 80304-3586
Country : US
Telephone Number : 303-440-3216
Fax Number : 303-440-3209
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2009
Last Update Date : 01/08/2026

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Directions to “ CHRISTIE BEAN BLANTON MD” Practice Location

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