Individual
DR. EMILY ELISABETH BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13825 S REDWOOD RD STE 200, BLUFFDALE, UT 84065-5255
(801) 569-2626
Mailing address
8414 NAAB RD STE 210, INDIANAPOLIS, IN 46260-1972
(317) 338-7510
(317) 338-7540
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
12872798-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2018
Last updated
06/16/2022
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