Individual provider · NPI-1

Dr. Miran Joel Blanchard, MD

· Fargo, ND

NPI number1629369830
StatusActive
Last updated in NPPESMar 25, 2022

Details

NPI
1629369830
Entity type
Individual (NPI-1)
Name
Dr. Miran Joel Blanchard
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Apr 21, 2011
Certification date
Mar 25, 2022
Last updated
Mar 25, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2085R0001X 13647NDYes
2085R0001X 105542MN
2085R0001X 54356MN
390200000X Student in an Organized Health Care Education/Training Program–ND

Practice location

820 4th St N
Fargo, ND 58102-4539

Phone 701-234-6161

Mailing address

820 4th St N
Fargo, ND 58102-4539

Phone 701-234-6161

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