Individual
MARJORIE C BLAKE
Active
Individual
MARJORIE C BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
37679
WI
207L00000X
Anesthesiology Physician
Primary
M-9609
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32230200
—
WI
05
—
8075089
—
ID
Enumeration date
06/02/2006
Last updated
08/20/2025
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