Individual
DR. SEAN BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
069875
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
069875
MEDICAL LICENSE
GA
01
—
52606838-001
BCBSGA
GA
01
—
600-88733
BCBS-AL
AL
01
—
S0431
TX MEDICAL LICENSE
TX
Enumeration date
07/06/2010
Last updated
10/30/2025
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