Blake Ervin Collison
Emergency Physician
407 E 3rd St
Duluth
, Minnesota 55805
Blake Ervin Collison
Emergency Physician
407 E 3rd St
Duluth
, Minnesota 55805
(701) 364-4222
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About
Features
Specialties
- Emergency Physician
Languages spoken
- English
Location
First Address
- Blake Ervin Collison
- 1702 University Dr S
- Fargo, ND
- Zip : 58103-4940
- Phone : (701) 364-4222
Second Address
- Blake Ervin Collison
- 407 E 3rd St
- Duluth, MN
- Zip : 55805
- Phone : (218) 786-4000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207P00000X | Emergency Physician | 63874 | MN |
National Provider Identifier
| NPI | 1003293804 |
|---|---|
| Provider Name | Blake Ervin Collison |
| First Address | Fargo, ND 58103-4940 |
| Second Address | Duluth, MN 55805 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/04/2015 |
| Last Update Date | 22/06/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.