Blake, Michael Joseph

Blake, Michael Joseph is an individual health care provider with primary practice located at 937 Highland Blvd Ste 5320 , Bozeman MT 59715-6916. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Blake, Michael Joseph can be contacted via phone (406) 414-4900.

Contact Information

Primary practice address
937 Highland Blvd Ste 5320 Bozeman MT 59715-6916
Phone: (406) 414-4900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 12120 Montana

Profile Details

NPI number 1578513701
LBN Legal business name Blake, Michael Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Jul 22nd, 2021 - about 4 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 1578513701 NPPES
Missouri MEDICAID 209287408
Missouri MEDICAID 1578513701

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