Blake, Donnevan
Blake, Donnevan is an individual health care provider with primary practice located at 744 S Webster Ave Fl 2 , Green Bay WI 54301-3505. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Blake, Donnevan can be contacted via phone (920) 433-3640.Contact Information
Primary practice address
744 S Webster Ave Fl 2
Green Bay WI 54301-3505
Phone: (920) 433-3640
Fax: (920) 433-3716
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 52766-20 | Wisconsin |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 4301095491 | Michigan |
Profile Details
| NPI number | 1801854898 |
|---|---|
| LBN Legal business name | Blake, Donnevan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 2nd, 2006 |
| Last updated | Jul 7th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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