John A Blake, PA-C
NPI #1780726570 in Shallotte, North Carolina
Provider Information
- NPI Number
- 1780726570
- Entity Type
- Individual
- Name
- John A Blake, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Feb 12, 2007
- Last Updated
- Jun 3, 2019
Practice Location
- Address
- 712 VILLAGE RD SW STE 104
- City
- Shallotte
- State
- North Carolina
- ZIP Code
- 28470-3449
- Phone
- (910) 754-7607
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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