Provider Demographics
NPI:1093962383
Name:ALLERGY AND ASTHMA CARE OF BLAKENEY, PLLC
Entity Type:Organization
Organization Name:ALLERGY AND ASTHMA CARE OF BLAKENEY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MCELDOWNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-752-3773
Mailing Address - Street 1:8840 BLAKENEY PROFESSIONAL DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-6807
Mailing Address - Country:US
Mailing Address - Phone:704-752-3773
Mailing Address - Fax:704-369-8788
Practice Address - Street 1:8840 BLAKENEY PROFESSIONAL DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-6807
Practice Address - Country:US
Practice Address - Phone:704-752-3773
Practice Address - Fax:704-369-8788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-19
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207K00000X
NC2008-00897207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty