NPI 1447901665 · live from the CMS NPI Registry
Zachary Ian Blake
Physician Assistant in Wilmington, NC. National Provider Identifier 1447901665, active.
NPI record
| NPI | 1447901665 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 2131 S 17th St, Wilmington, NC 28401 |
| Practice phone | 910-667-2606 |
| Mailing address | Po Box 936857, Atlanta, GA 31193 |
| Enumerated | January 11, 2022 |
| Last updated | April 29, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | 2726 (WV) |
| Physician Assistant primary | 363A00000X | 0010-15439 (NC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.