Spain, Blake A
Spain, Blake A is an individual health care provider with primary practice located at 920 Church St N , Concord NC 28025-2927. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Spain, Blake A can be contacted via phone (704) 403-1331.Contact Information
Primary practice address
920 Church St N
Concord NC 28025-2927
Phone: (704) 403-1331
Fax: (704) 403-2533
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 9800704 | North Carolina |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 9800704 | North Carolina |
Profile Details
| NPI number | 1952416331 |
|---|---|
| LBN Legal business name | Spain, Blake A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 19th, 2006 |
| Last updated | Jan 24th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952416331 | NPPES |
| North Carolina | Other | 1053H | BCBS ALL PLANS |
| North Carolina | Other | 9840261 | BCBS ALL PLANS |
| North Carolina | MEDICAID | 791053H | BCBS ALL PLANS |
| North Carolina | Other | 1281816 | BCBS ALL PLANS |
| North Carolina | Other | 200322 | BCBS ALL PLANS |
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