Individual
DR. DAVID PAUL BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 531-2246
(703) 237-7895
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101241616
VA
208600000X
Surgery Physician
61499
CT
2086S0102X
Surgical Critical Care Physician
0101241616
VA
2086S0102X
Surgical Critical Care Physician
35.093895
OH
2086S0102X
Surgical Critical Care Physician
61499
CT
2086S0127X
Trauma Surgery Physician
0101241616
VA
2086S0127X
Trauma Surgery Physician
35.093895
OH
2086S0127X
Trauma Surgery Physician
61499
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10106541
OPTIMA HEALTH
VA
01
—
1063484210
UNITED HEALTHCARE
VA
05
—
1063484210
—
NC
05
—
1063484210
—
VA
01
—
488414
ANTHEM BC/BS
VA
01
—
PAR
MULTIPLAN
VA
Enumeration date
02/02/2006
Last updated
06/21/2022
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