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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174502660 | NPPES |
| Massachusetts | Other | J12115 | BLUE CROSS BLUE SHIELD |
| Massachusetts | MEDICAID | 3089151 | BLUE CROSS BLUE SHIELD |
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