Provider Demographics
NPI:1760446959
Name:BLANCO, RAMON (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:
Last Name:BLANCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RAMON
Other - Middle Name:
Other - Last Name:BLANCO GONZALEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:17 BUXUS SHORES CIR
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-2678
Mailing Address - Country:US
Mailing Address - Phone:508-457-3536
Mailing Address - Fax:508-457-3641
Practice Address - Street 1:100 TER HEUN DR
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2503
Practice Address - Country:US
Practice Address - Phone:508-457-3536
Practice Address - Fax:508-457-3641
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA74874207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology