Blaylock, Wilmer Kenneth
Blaylock, Wilmer Kenneth is an individual health care provider with primary practice located at 1250 E Marshall St Dermatology -, Richmond VA 23298-5051. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Blaylock, Wilmer Kenneth can be contacted via phone (804) 828-9361.Contact Information
Primary practice address
1250 E Marshall St Dermatology -
Richmond VA 23298-5051
Phone: (804) 828-9361
Fax: (804) 828-9596
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 0101013569 | Virginia |
Profile Details
| NPI number | 1417982778 |
|---|---|
| LBN Legal business name | Blaylock, Wilmer Kenneth |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Jul 9th, 2007 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417982778 | NPPES |
| Virginia | MEDICAID | 5911761 |
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