Most Relevant Information
Provider Data
| NPI Number: | 1003033119 |
| Provider Name: | BRAD D. BLANKENHORN M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 207X00000X |
| Specialty: | Orthopaedic Surgery |
| License Number: | 2012-0546 |
Most Important Dates
| Enumeration Date: | 04/19/2007 |
| Last Updated: | 02/14/2019 |
Provider Practice Location
1 KETTLE POINT AVE
EAST PROVIDENCE
RI
029145375
Practice Location Phone/Fax
| Phone: | 4013301405 |
| Fax: | 4012770799 |
Provider Mailing Location
PO BOX 1119
PROVIDENCE
RI
029011119
Provider Mailing Phone/Fax
| Phone: | 4013301405 |
| Fax: | 4012770799 |
Suggested EMR
Orthopedic EMR