Individual
ERIC BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 E EISENHOWER PKWY, ANN ARBOR, MI 48108-3302
(734) 539-5080
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301511256
MI
390200000X
Student in an Organized Health Care Education/Training Program
4351047513
MI
Other
Enumeration date
05/20/2021
Last updated
08/27/2024
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