Individual
DOUGLAS BLAKE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
591 EDDY ST, DEPT OF ANESTHESIA, PROVIDENCE, RI 02903-4922
(401) 444-2284
(401) 444-5083
Mailing address
690 CANTON ST, STE 325, WESTWOOD, MA 02090-2324
(781) 407-7713
(781) 407-0998
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
RI8815
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DB12516
—
RI
Enumeration date
04/26/2006
Last updated
04/15/2016
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