Individual
BLAKE A CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3600 MINNESOTA DR STE 800, EDINA, MN 55435-7915
(952) 595-1301
(612) 294-4903
Mailing address
3600 MINNESOTA DR STE 800, EDINA, MN 55435-7915
(952) 595-1301
(612) 294-4903
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
32592
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
790329400
—
MN
Enumeration date
01/13/2006
Last updated
01/15/2025
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