DAVID P BLAKE (NPI# 1548233125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548233125 |
| Entity Type | Individual |
| Full Name | DAVID P BLAKE |
| Credential | MD |
| Practice Address |
640 Jackson Street Mc 11503k St Paul MN 55102-2502 |
| Mailing Address |
8100 34 Ave S Mail Stop 21110q Bloomington MN 55425-1672 |
| Practice Telephone | 6512543462 |
| Practice Fax Number | 6512541603 |
| Mailing Telephone | 9528835463 |
| Mailing Fax Number | 9528838395 |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
25966 | MN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649792565 | David Blake | Case Manager/Care Coordinator | 522 E. Lake Mead Parkway, Suite 5, Henderson, NV 89015 | 2017-07-12 |
| 1295837094 | David M Blake | Psychiatry & Neurology | 1221 S Broadway # D302, Lexington, KY 40504-2701 | 2006-09-02 |
| 1598266462 | David Blake | Physician Assistant | 1049 Main St, Springfield, MA 01103-2114 | 2018-02-26 |
| 1326054255 | David Allen Blake | Anesthesiology | 225 S Lake Ave, Suite 535, Pasadena, CA 91101-3005 | 2006-07-31 |
| 1831161348 | David Blake | Internal Medicine | 14555 W National Ave, Ste 192, New Berlin, WI 53151-4494 | 2006-02-07 |
| 1063484210 | David Paul Blake | Surgery | 3300 Gallows Rd, Falls Church, VA 22042-3307 | 2006-02-02 |
| Street Address |
640 JACKSON STREET MC 11503K |
| City | ST PAUL |
| State | MN |
| Zip Code | 55102-2502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306095336 | Chelsey Jane Tollefson-hauer | Social Worker | 640 Jackson Street, St Paul, MN 55101-2502 | 2008-09-15 |
| 1205085594 | Margaret Mary Gallus | Nurse Anesthetist, Certified Registered | 640 Jackson Street, Mail Stop 21110q, St Paul, MN 55101-2502 | 2008-09-11 |
| 1942473335 | Heather Ellsworth | Emergency Medicine | 640 Jackson Street, Regions Hospital, St Paul, MN 55101 | 2008-04-08 |
| 1982763660 | Gwendolyn A Polaski | Physician Assistant | 640 Jackson Street, St Paul, MN 55101-2502 | 2006-12-08 |
| 1750477626 | Carol C Hunter | Nurse Anesthetist, Certified Registered | 640 Jackson Street, Mail Stop 11503p, St Paul, MN 55101-2502 | 2006-10-05 |
| 1952408197 | Trent R Whitcomb | Physician Assistant | 640 Jackson Street, Mc 115031, St Paul, MN 55101-2502 | 2006-09-20 |
| 1992802060 | Steven G Kremer | Nurse Anesthetist, Certified Registered | 640 Jackson Street, Mail Stop 11503p, St Paul, MN 55101-2502 | 2006-09-20 |
| 1336250174 | Mitchell P Chermack | Nurse Anesthetist, Certified Registered | 640 Jackson Street, Mail Stop 11503p, St Paul, MN 55101-2502 | 2006-08-31 |
| 1386653889 | Rory S Kortan | Nurse Anesthetist, Certified Registered | 640 Jackson Street, Mail Stop 11503p, St Paul, MN 55101-2502 | 2006-08-05 |
| 1477580348 | Kristin M Sticha | Nurse Practitioner | 640 Jackson Street, St Paul, MN 55101-2502 | 2006-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720623366 | Ning Wu | Acupuncturist | Tcm Health Center, 613 Grand Ave., St. Paul, MN 55102 | 2019-11-07 |
| 1730730615 | Tianwei Guo | Acupuncturist | 613 Grand Avenue, Saint Paul, MN 55102 | 2019-09-23 |
| 1194374850 | Justin Crawford Diehl | Counselor | 976 Juno Avenue, Saint Paul, MN 55102 | 2019-09-05 |
| 1699329169 | Elisabeth Johanna Wurtmann | Genetic Counselor, MS | 310 N Smith Avenue Suite 300, Saint Paul, MN 55102 | 2019-08-01 |
| 1265907083 | Lillia Budd | Nurse Practitioner | 225 Smith Ave N - Suite 400, Mail Route 65400, Saint Paul, MN 55102 | 2018-10-08 |
| 1922505098 | Women of Nations | Substance Abuse Rehabilitation Facility | 73 Leech Street, St. Paul, MN 55102 | 2018-04-06 |
| 1609371939 | Courtney Marie Klinkhammer | Student in an Organized Health Care Education/Training Program | 1026 West Seventh Street, St. Paul, MN 55102 | 2018-03-28 |
| 1427429372 | Compass Pathology and Consulting | Clinical Medical Laboratory | 360 Sherman St Suite 400b, St. Paul, MN 55102 | 2015-10-16 |
| 1639550494 | Daniel Delapp | Speech-Language Pathologist | United Hospital 333 Smith Avenue N, Mail Route 60104, St. Paul, MN 55102 | 2015-06-17 |
| 1124419940 | Suzanne Carl | Speech-Language Pathologist | 360 Colborne Avenue, St. Paul, MN 55102 | 2015-02-16 |
| Find all providers in zip 55102 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598732687 | Arlen R Holter | Surgery | 640 Jackson St, Mc 11503k, St Paul, MN 55102-2502 | 2006-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265721757 | Yauhen Alexander Tarbunou | Surgery | 1200 6th Ave. N., St. Cloud, MN 56303-2735 | 2011-04-05 |
| 1083894836 | Vascular Surgery Associates Pa | Surgery | 3887 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2518 | 2007-11-09 |
| 1215947288 | Kamran Karimi | Surgery | 6405 France Ave S Ste W320, Edina, MN 55435-2188 | 2006-08-09 |
| 1649217159 | Roger S Hogue | Surgery | 7365 Kirkwood Ct N, Ste 120, Maple Grove, MN 55369-4721 | 2006-06-01 |
| 1720025455 | Rumi Faizer | Surgery | 314 Variety Club Research Center, 401 East River Parkway Division of Vascular Surgery, Minneapolis, MN 55455 | 2006-06-01 |
| 1518938067 | David Reed Knighton | Surgery | 2460 Highway 100 S, St Louis Park, MN 55416-1704 | 2006-01-31 |
| 1679100937 | Jesse Chait | Surgery | 200 1st St Sw, Rochester, MN 55905-0002 | 2020-03-26 |
| 1699235689 | Armin Farazdaghi | Surgery | 200 First Street Sw, Rochester, MN 55905-0001 | 2019-03-25 |
| 1093210262 | Nolan C Cirillo-penn | Surgery | 200 1st St Sw, Rochester, MN 55905 | 2018-03-28 |
| 1760915862 | Indrani Sen | Surgery | 200 1st St Sw, Mayo Clinic, Rochester, Rochester, MN 55905-0001 | 2017-04-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.