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Individual
DR. PAUL MAXWELL BLAKE III
Active
Individual
DR. PAUL MAXWELL BLAKE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20938
WV
207R00000X
Internal Medicine Physician
MD429954
PA
207R00000X
Internal Medicine Physician
Primary
ME143213
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017240800001
—
PA
01
—
105606
MEDICARE
PA
05
—
181232700
—
WV
01
—
1896405
HIGHMARK
PA
05
—
2341602
—
OH
05
—
64073695
—
KY
Enumeration date
06/29/2006
Last updated
04/02/2025
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