Blake, Paul S

Blake, Paul S is an individual health care provider with primary practice located at 3033 Eastway Dr Ste 201 , Charlotte NC 28205-6387. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Blake, Paul S can be contacted via phone (704) 731-6451.

Contact Information

Primary practice address
3033 Eastway Dr Ste 201 Charlotte NC 28205-6387
Phone: (704) 731-6451
Fax: (704) 731-6452
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 97-01697 North Carolina

Profile Details

NPI number 1871550855
LBN Legal business name Blake, Paul S
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Jul 6th, 2023 - about last year

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 1871550855 NPPES
North Carolina Other 276911 MAMSI
North Carolina MEDICAID N01697 MAMSI
North Carolina MEDICAID 891126N MAMSI
North Carolina Other 1126N MAMSI
North Carolina Other 17696 MAMSI
North Carolina Other 390006903 MAMSI
North Carolina Other 561550231M MAMSI

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