Provider Demographics
NPI:1558322065
Name:BLANKENBAKER, DONNA G (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:G
Last Name:BLANKENBAKER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:608-829-5485
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792
Practice Address - Country:US
Practice Address - Phone:608-263-8340
Practice Address - Fax:608-265-6533
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2021-01-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI390152085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology