Individual
DR. BRIAN J BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4760 BELPAR ST NW, CANTON, OH 44718-3603
(330) 492-9200
(330) 492-5454
Mailing address
4760 BELPAR ST NW, CANTON, OH 44718-3603
(330) 492-9200
(330) 492-5454
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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