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General NPI Number Information
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NPI Number | 1063484210
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Entity Type | Individual
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Provider Name | DAVID PAUL BLAKE MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 06/21/2022
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Provider Practice Location Address
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Address Line | 3300 GALLOWS RD
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City | FALLS CHURCH
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State | VA
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Zip | 22042-3307
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Country | US
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Telephone | 703-531-2246
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Fax | 703-237-7895
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Provider Business Mailing Address
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Address Line | PO BOX 37174
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City | BALTIMORE
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State | MD
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Zip | 21297-3174
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Country | US
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Telephone | 571-423-5699
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Fax | 571-423-5698
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 35.093895
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 61499
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 61499
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 0101241616
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 0101241616
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License Number State | VA
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Taxonomy #6
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 35.093895
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License Number State | OH
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Taxonomy #7
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 61499
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License Number State | CT
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Taxonomy #8
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0101241616
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License Number State | VA
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