Provider Demographics
NPI:1497174189
Name:RAGGIO, BLAKE STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:BLAKE
Middle Name:STEPHEN
Last Name:RAGGIO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1722 PINE ST STE 203
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1158
Mailing Address - Country:US
Mailing Address - Phone:334-293-8736
Mailing Address - Fax:334-293-8738
Practice Address - Street 1:1111 OLIVE ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1129
Practice Address - Country:US
Practice Address - Phone:334-834-7221
Practice Address - Fax:334-241-9848
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2020-07-17
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Provider Licenses
StateLicense IDTaxonomies
ALMD.40981207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck