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DEDRA I BLALOCK NPI 1619063153


NPI Information

NPI: 1619063153
Provider Name: DEDRA I BLALOCK
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

PECOS Registration: Yes

Address:
550 PEACHTREE ST
ATLANTA, GA
ZIP 30308
Phone: (404) 686-7431
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Dedra I Blalock is a cardiovascular disease internal medicine in Atlanta, GA with 21 years of experience. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. Dedra I Blalock NPI is 1619063153. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

550 PEACHTREE ST
ATLANTA, GA
ZIP 30308
Phone: (404) 686-7431

The NPI 1619063153 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/4/2006 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RC0000XInternal MedicineCardiovascular DiseaseRN089049NPGEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.