Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. ROGER ALAN BLAKE, M.D.
Active Sole ProprietorDR. ROGER ALAN BLAKE, M.D. is a Surgical Critical Care healthcare provider located in CLEVELAND, Mississippi. NPI 1023049335 is currently active in the NPPES registry. Verify at CMS.
Surgical Critical Care · CLEVELAND, MS
Registration Details
- NPI Number
- 1023049335
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 5, 2006 (20.135135925189 yrs)
- Last Updated
- Mar 4, 2024
- Licenses
-
16881 (MS)MC-2670 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
907 E SUNFLOWER RD101CLEVELAND, MS, 387322830Browse MS providers · Browse ZIP 38732
- Phone
- 6628468880
- Fax
- 6628468886
- Primary Specialty
-
Surgical Critical Care
2086S0102X
- Additional Specialty
- Surgical Critical Care
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.