Blakeman, Stephen Dale

Blakeman, Stephen Dale is an individual health care provider with primary practice located at 1012 Cedar Knoll Dr , Wake Forest NC 27587-6248. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Blakeman, Stephen Dale can be contacted via phone (919) 554-4343.

Contact Information

Primary practice address
1012 Cedar Knoll Dr Wake Forest NC 27587-6248
Phone: (919) 554-4343
Fax: (877) 300-6893
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1556 North Carolina

Profile Details

NPI number 1972507309
LBN Legal business name Blakeman, Stephen Dale
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated May 20th, 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 1972507309 NPPES
North Carolina Other 142A0 BCBS
North Carolina MEDICAID 6107254 BCBS

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