Blake, Stephen David

Blake, Stephen David is an individual health care provider with primary practice located at 249 N Grove Medical Park Dr Ste 100 , Spartanburg SC 29303-4227. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Blake, Stephen David can be contacted via phone (864) 582-8135.

Contact Information

Primary practice address
249 N Grove Medical Park Dr Ste 100 Spartanburg SC 29303-4227
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics 2080P0006X 26859 South Carolina
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 26859 South Carolina

Profile Details

NPI number 1538111588
LBN Legal business name Blake, Stephen David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Mar 29th, 2023 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538111588 NPPES
South Carolina MEDICAID 268597

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