BRUCE GARY BLANK DPM NPI 1790757490

NPI Information

NPI: 1790757490
Provider Name: BRUCE GARY BLANK, DPM
Classification: Podiatrist - 213E00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
92 N 4TH ST
SUITE 27
MARTINS FERRY, OH
ZIP 43935
Phone: (740) 633-4188
Get Directions

Bruce Gary Blank, DPM is a podiatrist in Martins Ferry, OH. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. Bruce Gary Blank, DPM NPI is 1790757490. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

92 N 4TH ST
SUITE 27
MARTINS FERRY, OH
ZIP 43935-691
Phone: (740) 633-4188
Fax: (740) 633-4716

The NPI 1790757490 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 2/6/2006 and was last updated on 3/19/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213E00000X	Podiatrist		00239	WEST VIRGINIA	No
2	213E00000X	Podiatrist		36002569	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6491296002	OTHER		CIGNA
2	0747213	MEDICAID	OHIO
3	480027937	OTHER		RAILROAD MEDICARE
4	BL0644229	MEDICARE ID-TYPE UNSPECIFIED	OHIO
5	000000141557	OTHER	OHIO	ANTHEM BCBC
6	4295099	OTHER		AETNA
7	BL0644228	MEDICARE ID-TYPE UNSPECIFIED	OHIO
8	BL0882671	MEDICARE ID-TYPE UNSPECIFIED	WEST VIRGINIA
9	2569	OTHER	OHIO	HEALTH PLAN
10	01548623	MEDICAID	PENNSYLVANIA
11	0099535000	MEDICAID	WEST VIRGINIA
12	2102991	OTHER		MAMSI
13	T42360	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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