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
Phone: (757) 934-4222
Fax: (757) 934-4111
Website:
Health care specialties
| Specialty | Code | License # | 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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