Blaker, Brad A

Blaker, Brad A is an individual health care provider with primary practice located at 50 N Perry St , Pontiac MI 48342-2217. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Blaker, Brad A can be contacted via phone (248) 338-5327.

Contact Information

Primary practice address
50 N Perry St Pontiac MI 48342-2217
Phone: (248) 338-5327
Fax: (248) 338-5129
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 34.016136 Ohio
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 5101013885 Michigan
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 83418 South Carolina

Profile Details

NPI number 1790769545
LBN Legal business name Blaker, Brad A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2005
Last updated Sep 15th, 2022 - about 2 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 1790769545 NPPES
Michigan MEDICAID 4504220

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