Provider Demographics
NPI:1336323146
Name:STEVEN S. BLANKEN,D.P.M.
Entity Type:Organization
Organization Name:STEVEN S. BLANKEN,D.P.M.
Other - Org Name:STEVEN S. BLANKEN,D.P.M.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-592-0505
Mailing Address - Street 1:10313 GEORGIA AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-5006
Mailing Address - Country:US
Mailing Address - Phone:301-592-0505
Mailing Address - Fax:301-592-0503
Practice Address - Street 1:10313 GEORGIA AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5006
Practice Address - Country:US
Practice Address - Phone:301-592-0505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD162029OtherHIGHMARK MEDICARE
MD88280001OtherBCBS CAREFIRST
MD450798300Medicaid
MDU33103Medicare UPIN
MD446824Medicare PIN
MD88280001OtherBCBS CAREFIRST