Individual
DR. BLAKE HARRISON PRIDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
355 W 16TH ST STE 5100, INDIANAPOLIS, IN 46202-2274
(317) 396-1234
Mailing address
355 W 16TH ST STE 5100, INDIANAPOLIS, IN 46202-2274
(317) 396-1234
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11019795A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11019795A
IN
Other
Enumeration date
05/14/2018
Last updated
06/02/2021
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