Provider Demographics
NPI:1477631893
Name:BLIKE, GEORGE TIMOTHY (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:TIMOTHY
Last Name:BLIKE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:DHMC. DEPARTMENT OF ANESTHESIOLOGY
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-650-5922
Mailing Address - Fax:603-650-8980
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DHMC. DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-5922
Practice Address - Fax:603-650-8980
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2011-07-26
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH8733207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0002237Medicaid
NH80002237Medicaid
VT0002237Medicaid
NHAX4313Medicare PIN