Individual
DR. BRIAN J BLAKE
Active
Individual
DR. BRIAN J BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
35095075
OH
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
A106986
CA
Other
Enumeration date
09/20/2008
Last updated
03/18/2011
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