Blake, Michael Clarence

Blake, Michael Clarence is an individual health care provider with primary practice located at 2790 Godwin Blvd Ste 305, Suffolk VA 23434-8151. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Blake, Michael Clarence can be contacted via phone (757) 934-4222.

Contact Information

Primary practice address
2790 Godwin Blvd Ste 305 Suffolk VA 23434-8151
Fax: (757) 934-4111
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 0101023774 Virginia

Profile Details

NPI number 1063474955
LBN Legal business name Blake, Michael Clarence
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated Nov 13th, 2012 - about 13 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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