Provider Demographics
NPI:1215982392
Name:BLECHMAN, GARY (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:
Last Name:BLECHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3408 FALLSTAFF RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-1725
Mailing Address - Country:US
Mailing Address - Phone:410-740-7559
Mailing Address - Fax:410-884-4584
Practice Address - Street 1:5755 CEDAR LN
Practice Address - Street 2:HOWARD COUNTY GENERAL HOSPITAL
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2912
Practice Address - Country:US
Practice Address - Phone:410-740-7559
Practice Address - Fax:410-884-4584
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXT92922080N0001X
PAMD4803992080N0001X
MDD399172080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD068801100Medicaid