Individual
DR. BLAKE KNUDSON ISOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
111 S FRONT ST, HARRISBURG, PA 17101-2010
(717) 988-0000
(717) 782-5716
Mailing address
409 S 2ND ST, SUITE 2F, HARRISBURG, PA 17104-1612
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS016812
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102949254
—
PA
Enumeration date
06/02/2011
Last updated
01/16/2021
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