Individual
DR. WILLIAM J BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2019 GALISTEO ST STE K, SANTA FE, NM 87505-2159
(505) 982-0123
(505) 982-5714
Mailing address
2019 GALISTEO ST STE K, SANTA FE, NM 87505-2159
(505) 982-0123
(505) 982-5714
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
280
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201035866
PRESBYTERIAN HP
NM
05
—
75222353
—
NM
01
—
NM005445
BLUE CROSS BLUE SHIELD
NM
01
—
P00414656
RAILROAD MEDICARE
NM
01
—
PROVP11835
MOLINA
NM
Enumeration date
08/10/2006
Last updated
02/14/2014
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