Provider Demographics
NPI:1225013527
Name:BLECKER, UWE (MD)
Entity Type:Individual
Prefix:DR
First Name:UWE
Middle Name:
Last Name:BLECKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8331 N DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-6094
Mailing Address - Country:US
Mailing Address - Phone:850-505-4700
Mailing Address - Fax:850-505-4765
Practice Address - Street 1:8331 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-6094
Practice Address - Country:US
Practice Address - Phone:505-054-7008
Practice Address - Fax:850-505-4765
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1421292080P0206X
MS231202080P0206X
MTMED-PHYS-LIC-576452080P0206X
LAMD11619R2080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05687835Medicaid
AZ522806Medicaid
MS357479YJ5DMedicare PIN
MS387294YWZ1Medicare PIN
AZ522806Medicaid
AZ522806Medicaid