Smith, Blake D.

Smith, Blake D. is an individual health care provider with primary practice located at 2364 Washington St , Newton MA 02462-1440. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Smith, Blake D. can be contacted via phone (617) 332-2047.

Contact Information

Primary practice address
2364 Washington St Newton MA 02462-1440
Phone: (617) 332-2047
Fax: (617) 332-7341
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 75302 Massachusetts

Profile Details

NPI number 1174502660
LBN Legal business name Smith, Blake D.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 12th, 2006
Last updated Apr 10th, 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 1174502660 NPPES
Massachusetts Other J12115 BLUE CROSS BLUE SHIELD
Massachusetts MEDICAID 3089151 BLUE CROSS BLUE SHIELD

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