Provider Demographics
NPI:1922048560
Name:BLANCHARD, LINDA D (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:D
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7830 MCFARLAND LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-4705
Mailing Address - Country:US
Mailing Address - Phone:317-865-2700
Mailing Address - Fax:317-865-2711
Practice Address - Street 1:7830 MCFARLAND LN
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-4705
Practice Address - Country:US
Practice Address - Phone:317-865-2700
Practice Address - Fax:317-865-2711
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1033732208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100388510Medicaid