Provider Demographics
NPI:1598769440
Name:BLEDAY, RAYMOND M (DPM, MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:M
Last Name:BLEDAY
Suffix:
Gender:M
Credentials:DPM, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15245
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32406-5245
Mailing Address - Country:US
Mailing Address - Phone:850-257-5090
Mailing Address - Fax:850-872-9059
Practice Address - Street 1:410 W 19TH ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4602
Practice Address - Country:US
Practice Address - Phone:850-215-1246
Practice Address - Fax:850-215-1248
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD057331L207X00000X
FLME105356207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00220105OtherRAILROAD MEDICARE
PA214936OtherUPMC
PA108123OtherMEDIPLUS
PA1527981OtherGATEWAY HEALTH PLAN
FL146AHOtherBCBS
PA000268022OtherHIGHMARK BCBS
FL001387400Medicaid
PA001751281Medicaid
FLCI047XMedicare PIN
FLCI047WMedicare PIN
PA001751281Medicaid
PA214936OtherUPMC