Individual
DR. ROBERT ERNEST BLEASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2177 W IRONWOOD CENTER DR, COEUR D ALENE, ID 83814-2639
(208) 625-6111
(208) 625-6112
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-6111
(208) 625-6112
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M-16171
ID
207X00000X
Orthopaedic Surgery Physician
MED-PHYS-LIC-69984
MT
207XX0801X
Orthopaedic Trauma Physician
ME108720
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010324800
—
FL
01
—
HQ038X
MEDICARE
FL
01
—
HQ038Y
MEDICARE
FL
Enumeration date
04/11/2007
Last updated
04/26/2024
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