Individual
BLAKE ROBERT SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3650 STEVE REYNOLDS BLVD DEPT OF, DULUTH, GA 30096-4506
(404) 365-0966
Mailing address
9500 EUCLID AVE, HEAD AND NECK INSTITUTE, CLEVELAND CLINIC, CLEVELAND, OH 44195-0001
(216) 444-4949
(216) 636-1548
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
079904
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2013
Last updated
01/17/2019
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