Blake, Andrea

Blake, Andrea is an individual health care provider with primary practice located at 4102 Pinion Dr General Surgery, Usaf Academy CO 80840-2502. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Blake, Andrea can be contacted via phone (719) 333-5140.

Contact Information

Primary practice address
4102 Pinion Dr General Surgery Usaf Academy CO 80840-2502
Phone: (719) 333-5140
Fax: (719) 333-5836
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X DR0052469 Colorado

Profile Details

NPI number 1952551871
LBN Legal business name Blake, Andrea
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2008
Last updated Nov 21st, 2013 - about 12 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 1952551871 NPPES
Colorado MEDICAID 91585783

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