Blankenheim, Luke Johnathan

Blankenheim, Luke Johnathan is an individual health care provider with primary practice located at 8926 Woodyard Rd Suite 701, Clinton MD 20735-4220. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Blankenheim, Luke Johnathan can be contacted via phone (301) 856-1682.

Contact Information

Primary practice address
8926 Woodyard Rd Suite 701 Clinton MD 20735-4220
Phone: (301) 856-1682
Fax: (301) 856-8214
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X C0004416 Maryland

Profile Details

NPI number 1174829774
LBN Legal business name Blankenheim, Luke Johnathan
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2011
Last updated Feb 13th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174829774 NPPES
Other CI2264 RAILROAD MEDICARE GROUP PTAN
Other C0004416 RAILROAD MEDICARE GROUP PTAN
Other P00992732 RAILROAD MEDICARE GROUP PTAN

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