| Blake Gastroenterology Associates, Llc | |
|
6827-31 Germantown Ave Philadelphia PA 19119-2113 | |
| (215) 849-4902 | |
| (215) 849-4907 |
| Full Name | Blake Gastroenterology Associates, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6827-31 Germantown Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | James Steven Blake (CEO) |
| Authorized Official Contact | 2158494902 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blake Gastroenterology Associates, Llc 6827-31 Germantown Ave Philadelphia PA 19119-2113 Ph: (215) 849-4902 | Blake Gastroenterology Associates, Llc 6827-31 Germantown Ave Philadelphia PA 19119-2113 Ph: (215) 849-4902 |
| NPI Number | 1386729705 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 06/27/2012 |
| Medicare PECOS PAC ID | 0648242685 |
|---|---|
| Medicare Enrollment ID | O20040810000714 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386729705 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | OS007404E (Pennsylvania) | Primary |
| Provider Name | James S Blake |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1720176381 PECOS PAC ID: 1254350473 Enrollment ID: I20120120000284 |
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