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General NPI Number Information
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NPI Number | 1245438597
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Entity Type | Individual
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Provider Name | HELEN MAUREEN BLAKE M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/09/2007
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Last Update Date | 11/01/2018
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Provider Practice Location Address
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Address Line | 14825 NORTH OUTER 40 RD STE 360
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2108
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Country | US
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Telephone | 314-336-2570
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Fax | 314-336-2571
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Provider Business Mailing Address
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Address Line | 14825 NORTH OUTER 40 RD STE 360
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2108
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Country | US
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Telephone | 314-336-2570
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Fax | 314-336-2571
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 2007016653
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 260816
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 2007016653
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 2012021214
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License Number State | MO
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