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Contact Information

WILLIAM J BLAKE, DPM
2019 GALISTEO ST STE K
SANTA FE, NM87505-2159
 Phone: 505-982-0123
 Fax: 505-982-5714
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for WILLIAM J BLAKE · (Male)

NPI # 1831100502
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 08/10/2006
Last updated 02/14/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 280
  • NM Medicaid 75222353
  • NM Other NM005445 BLUE CROSS BLUE SHIELD
  • NM Other PROVP11835 MOLINA
  • NM Other 201035866 PRESBYTERIAN HP
  • NM Other P00414656 RAILROAD MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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