Individual
DAVID P BLAKE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
640 JACKSON STREET, MC 11503K, ST PAUL, MN 55102-2502
(651) 254-3462
(651) 254-1603
Mailing address
8100 34 AVE S, MAIL STOP 21110Q, BLOOMINGTON, MN 55425-1672
(952) 883-5463
(952) 883-8395
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
25966
MN
Other
Enumeration date
02/13/2006
Last updated
07/08/2007
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