Provider Demographics
NPI:1659340131
Name:BLANCHARD, PAUL L (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:L
Last Name:BLANCHARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7665 MONARCH CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2497
Mailing Address - Country:US
Mailing Address - Phone:513-777-8300
Mailing Address - Fax:513-777-0431
Practice Address - Street 1:7665 MONARCH CT
Practice Address - Street 2:SUITE 101
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2497
Practice Address - Country:US
Practice Address - Phone:513-777-8300
Practice Address - Fax:513-777-0431
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35079460207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2419369Medicaid
OHF96431Medicare UPIN
OH4116959Medicare PIN