Individual
PAUL BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
420 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0341
(612) 873-3000
Mailing address
420 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0341
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
23235
ND
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/05/2021
Last updated
03/19/2026
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