Blalock, Clyde P.

Blalock, Clyde P. is an individual health care provider with primary practice located at 955 Ribaut Rd , Beaufort SC 29902-5441. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Blalock, Clyde P. can be contacted via phone (843) 522-5130.

Contact Information

Primary practice address
955 Ribaut Rd Beaufort SC 29902-5441
Phone: (843) 522-5130
Fax: (843) 522-5538
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 21036 South Carolina

Profile Details

NPI number 1396782488
LBN Legal business name Blalock, Clyde P.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Jan 9th, 2008 - about 17 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 1396782488 NPPES
South Carolina MEDICAID G24901

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