Individual
DAVID BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14555 W NATIONAL AVE, STE 192, NEW BERLIN, WI 53151-4494
(262) 827-2959
(262) 827-2948
Mailing address
100-15TH AVE, STE 180, SOUTH MILWAUKEE, WI 53172-1160
(414) 827-2959
(262) 827-2948
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
Primary
19654
WI
Other
Enumeration date
02/07/2006
Last updated
03/14/2013
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