Individual
BLAKE ERVIN COLLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
407 E 3RD ST, DULUTH, MN 55805
(218) 786-4000
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-4222
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
63874
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2015
Last updated
06/22/2018
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