# DR. BLAKE ANDERSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1093798134
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | 2009013290 | MO | — |
| 207Q00000X | Family Medicine Physician | 2009013290 | MO | Yes |

## Other

- **Enumeration date:** 11/22/2005
- **Last updated:** 09/29/2026

## 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 |