Individual
MARK ANDREW BLAKESLEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
OS007656L
PA
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
OS007656L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118438711
DEPARTMENT OF LABOR
PA
01
—
170622
BLUE SHIELD
PA
05
—
18423860001
—
PA
01
—
232809429
TRICARE
PA
01
—
50002761
KEYSTONE
PA
01
—
645269046
GEISINGER
PA
01
—
G47849
HEALTH AMERICA
PA
01
—
P00170649
RAILROAD MEDICARE
PA
Enumeration date
07/18/2006
Last updated
06/07/2022
Update your record
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