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Individual
BLAKE PETERSON
Active
Individual
BLAKE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
T60-2016
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
000930
AZ
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DP207320
OR
Other
Enumeration date
07/20/2016
Last updated
01/02/2026
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