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Individual
DR. BLAKE ANDERSON
Active
Individual
DR. BLAKE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2009013290
MO
207Q00000X
Family Medicine Physician
Primary
2009013290
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-13048
MEDICA
MN
01
—
1019018
ARAZ
MN
05
—
1093798134
—
MO
05
—
150459
—
MN
05
—
16690100
—
MN
01
—
21955
SIOUX VALLEY HEALTH PLANS
MN
01
—
67Q18AN
BLUE CROSS/BLUE PLUS
MN
01
—
7291
AVERA
MN
01
—
A035
CHAMPUS
MN
01
—
HP30702
HEALTHPARTNERS
MN
01
—
MH9041023739
PREFERRED ONE
MN
Enumeration date
11/22/2005
Last updated
09/29/2026
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