NPI Lookup
NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

BRAD D BLANKENHORN, MD
1 KETTLE POINT AVE
EAST PROVIDENCE, RI02914-5375
 Medical school:
UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE
Graduated 2005

 Phone: 401-330-1405
 Fax: 401-277-0799
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for BRAD D BLANKENHORN · (Male)

NPI # 1003033119
Status Active
Credentials MD
Entity Individual
Enumeration date 04/19/2007
Last updated 02/14/2019 - About 6 months ago
Sole proprietor 1 Yes
Identifiers
  • NM License # 2012-0546
  • RI License # MD13206
  • RI Medicaid BB81009
  • RI Other 110087299A MASSHEALTH
Hospital affiliation(s)
  • MIRIAM HOSPITAL - (Acute Care)
    164 SUMMIT AVENUE
    PROVIDENCE, RI 02906
  • RHODE ISLAND HOSPITAL - (Acute Care)
    593 EDDY STREET
    PROVIDENCE, RI 02902
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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