Blake, Michael G

Blake, Michael G is an individual health care provider with primary practice located at 124 W Coal Ave , Gallup NM 87301-6206. He recently has 6 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Blake, Michael G can be contacted via phone (505) 722-2020.

Contact Information

Primary practice address
124 W Coal Ave Gallup NM 87301-6206
Fax: (505) 863-2204
Website:

Health care specialties

Profile Details

NPI number 1831161264
LBN Legal business name Blake, Michael G
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2006
Last updated Dec 11th, 2008 - about 16 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 1831161264 NPPES
New Mexico Other NM00O520 BLUE CROSS BLUE SHIELD NM

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