Blake, William J
Blake, William J is an individual health care provider with primary practice located at 2019 Galisteo St Ste K , Santa Fe NM 87505-2159. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Blake, William J can be contacted via phone (505) 982-0123.Contact Information
Primary practice address
2019 Galisteo St Ste K
Santa Fe NM 87505-2159
Phone: (505) 982-0123
Fax: (505) 982-5714
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 280 | New Mexico |
Profile Details
NPI number | 1831100502 |
---|---|
LBN Legal business name | Blake, William J |
Credentials | Doctor of Podiatric Medicine (DPM) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 10th, 2006 |
Last updated | Feb 14th, 2014 - about 10 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1831100502 | NPPES |
New Mexico | Other | NM005445 | BLUE CROSS BLUE SHIELD |
New Mexico | Other | PROVP11835 | BLUE CROSS BLUE SHIELD |
New Mexico | MEDICAID | 75222353 | BLUE CROSS BLUE SHIELD |
New Mexico | Other | 201035866 | BLUE CROSS BLUE SHIELD |
New Mexico | Other | P00414656 | BLUE CROSS BLUE SHIELD |
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