Provider Demographics
NPI:1225013527
Name:BLECKER, UWE (MD)
Entity type:Individual
Prefix:DR
First Name:UWE
Middle Name:
Last Name:BLECKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 VALLEY CHILDRENS PL # SC05
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93636-8761
Mailing Address - Country:US
Mailing Address - Phone:559-353-5700
Mailing Address - Fax:559-353-5708
Practice Address - Street 1:9300 VALLEY CHILDRENS PL # SC05
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636-8761
Practice Address - Country:US
Practice Address - Phone:559-353-5700
Practice Address - Fax:559-353-5708
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME142129207RG0100X, 2080P0206X
CAC1950492080P0206X
LAMD11619R2080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ522806Medicaid
MS05687835Medicaid
MS357479YJ5DMedicare PIN
MS387294YWZ1Medicare PIN
AZ522806Medicaid
AZ522806Medicaid