Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JEROME M BLAKE, MD
ActiveNeurodevelopmental Disabilities · SIOUX FALLS, SD
Registration Details
- NPI Number
- 1699760546
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 16, 2005 (20.597885595101 yrs)
- Last Updated
- Mar 13, 2015
- License
-
2228 (SD)
Practice Information
- Address
-
1600 W 22ND STSIOUX FALLS, SD, 571051521Browse SD providers · Browse ZIP 57105
- Phone
- 6053121000
- Fax
- 6053121001
- Primary Specialty
-
Neurodevelopmental Disabilities
2080P0008X
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.