Individual
WILLIAM EDWARD BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4740 S I 10 SERVICE RD W, METAIRIE, LA 70001-1234
(504) 883-3703
(504) 883-3704
Mailing address
298 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
(504) 896-9827
(504) 894-5370
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
011575
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174891
—
LA
Enumeration date
06/09/2005
Last updated
02/02/2011
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