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:
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Health care specialties

SpecialtyCodeLicense #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 11 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 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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