Individual
MICHAEL J BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
410 W 10TH AVE, COLUMBUS, OH 43210-1240
(614) 293-8487
(614) 293-8153
Mailing address
700 ACKERMAN RD STE 2120, COLUMBUS, OH 43202-1559
(614) 293-8487
(614) 293-8153
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35.053889
OH
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
35-053889
OH
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
35.053889
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10826581
CAQH
OH
05
—
2016437
—
OH
Enumeration date
01/12/2006
Last updated
02/27/2026
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