MEDICARE: RONALD E BLANTON 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
1	207RI0200X	Infectious Disease Physician	35047704	OH

General Provider Information

NPI Number	:	1801933163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD E BLANTON M.D.

Provider Business Mailing Address
First Line	:	WOLSTEIN RESEARCH BUILDING, W4133
Second Line	:	2103 CORNELL ROAD
City	:	CLEVELAND
State	:	OH
Zip	:	44106-7286
Country	:	US
Telephone Number	:	216-368-4814
Fax Number	:	216-368-4825

Provider Business Practice Location Address
First Line	:	LOUIS STOKES CLEVELAND VA MEDICAL CENTER
Second Line	:	10701 EAST BOULEVARD
City	:	CLEVELAND
State	:	OH
Zip	:	44106
Country	:	US
Telephone Number	:	216-791-3800
Fax Number	:

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	07/08/2007

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