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
Fax: (920) 433-3716
Website:

Health care specialties

SpecialtyCodeLicense #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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