Provider Demographics
NPI:1275575987
Name:BLECKNER, STEVEN A (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:A
Last Name:BLECKNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2101 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4053
Mailing Address - Country:US
Mailing Address - Phone:301-681-5400
Mailing Address - Fax:301-681-5806
Practice Address - Street 1:2101 MEDICAL PARK DR
Practice Address - Street 2:SUITE 110
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-4053
Practice Address - Country:US
Practice Address - Phone:301-681-5400
Practice Address - Fax:301-681-5806
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0057506207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD454650400Medicaid
MD632753OtherNCPPO
MDB699 005OtherCAREFIRST BCBS NCA
MD2140312OtherUNITED HEALTHCARE
MD2689756OtherAETNA
MDB699 0005OtherCARE FIRST BCBS NATIONAL ACCOUNT
MDB699 0005OtherBCBS BLUE CHOICE
MD2000042728OtherRAILROAD MEDICARE
MD295848OtherMAMSI
MD632753OtherUNICARE
MDB699 0005OtherBLUE CHOICE OPEN ACESS
MD61179401OtherCARE FIRST BCBS MARYLAND
H50570Medicare UPIN
MD008312076Medicare PIN