Dr KELLY A BLAKE is a female medical professional, specializing in Physician Assistant. She graduated in 2007.
PANSURIYA CLINICAL CORPORATION
2111 HANOVER PIKE
HAMPSTEAD
MD
210741319
Tel: 4102397073
Npi | 1942487673 |
Pac Id | 0547347924 |
Professional Enrollment Id | I20080409000522 |
Last Name | BLAKE |
First Name | KELLY |
Middle Name | A |
Suffix | |
Gender | F |
Credential | |
Medical School Name | OTHER |
Graduation Year | 2007 |
Primary Specialty | PHYSICIAN ASSISTANT |
Secondary Specialty 1 | |
Secondary Specialty 2 | |
Secondary Specialty 3 | |
Secondary Specialty 4 | |
All Secondary Specialties | |
Organization Legal Name | PANSURIYA CLINICAL CORPORATION |
Group Practice Pac Id | 2365505435 |
Number Of Group Practice Members | 3 |
Line 1 Street Address | 2111 HANOVER PIKE |
Line 2 Street Address | |
Marker Of Address Line 2 Suppression | |
City | HAMPSTEAD |
State | MD |
Zip Code | 210741319 |
Phone Number | 4102397073 |
Hospital Affiliation Ccn 1 | 210033 |
Hospital Affiliation Lbn 1 | CARROLL HOSPITAL CENTER |
Hospital Affiliation Ccn 2 | 390233 |
Hospital Affiliation Lbn 2 | HANOVER HOSPITAL |
Hospital Affiliation Ccn 3 | 210012 |
Hospital Affiliation Lbn 3 | SINAI HOSPITAL OF BALTIMORE |
Hospital Affiliation Ccn 4 | |
Hospital Affiliation Lbn 4 | |
Hospital Affiliation Ccn 5 | |
Hospital Affiliation Lbn 5 | |
Professional Accepts Medicare Assignment | Y |
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