Blake, Douglas

Blake, Douglas is an individual health care provider with primary practice located at 591 Eddy St Dept Of Anesthesia, Providence RI 02903-4922. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Blake, Douglas can be contacted via phone (401) 444-2284.

Contact Information

Primary practice address
591 Eddy St Dept Of Anesthesia Providence RI 02903-4922
Phone: (401) 444-2284
Fax: (401) 444-5083
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X RI8815 Rhode Island

Profile Details

NPI number 1104883123
LBN Legal business name Blake, Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Apr 15th, 2016 - about 10 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 1104883123 NPPES
Rhode Island MEDICAID DB12516

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