Provider Demographics
NPI:1598885436
Name:BLAKE & SLOAN PC
Entity Type:Organization
Organization Name:BLAKE & SLOAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:A
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-684-4581
Mailing Address - Street 1:1450 MERCANTILE LN
Mailing Address - Street 2:SUITE 111
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5376
Mailing Address - Country:US
Mailing Address - Phone:301-925-7610
Mailing Address - Fax:301-925-7619
Practice Address - Street 1:1450 MERCANTILE LN
Practice Address - Street 2:SUITE 111
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5376
Practice Address - Country:US
Practice Address - Phone:301-925-7610
Practice Address - Fax:301-925-7619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDCIGNAOtherCIGNA
MDKCT4BLOtherCAREFIRST - MD
DC0478-0003OtherCAREFIRST-FED - DR. SLOAN
DC04780002OtherCAREFIRST-FED - DR BLAKE
MDKCT4BLOtherCAREFIRST - MD
MDCIGNAOtherCIGNA
MDCIGNAOtherCIGNA
MDF29684Medicare UPIN
MD=========OtherAETNA