Doctor Name: | SAMUEL BLEA |
NPI Number: | 1841629052 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 00022536 |
Business Practice Address: | 606 Colbert Avenue Springer, NM - 877470488 |
Business Phone Number: | 5754832682 |
Business Fax Number: | 5754832670 |
Mailing Address: | Po Box 488, SPRINGER |
State: | NM |
Postal Code: | 877470488 |
Phone Number: | 5754832682 |
Fax Number: | 5754832670 |
NPI Enumeration Date: | 11/07/2013 |
NPI Last Update Date: | 11/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 146M00000X |
License Number: | 00022536 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Emergency Medical Service Providers |
Taxonomy Classification: | Emergency Medical Technician, Intermediate |
Taxonomy Specialization: | |
Taxonomy Definition: | An Intermediate EMT is an individual trained and certified to perform intermediate life support treatment in medical emergencies based on individual state boards. |