DR. DOREEN BLAKE (NPI# 1043209331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043209331 |
| Entity Type | Individual |
| Full Name | DR. DOREEN BLAKE |
| Credential | M.D. |
| Practice Address |
1450 Mercantile Ln Suite 111 Largo MD 20774-5376 |
| Mailing Address |
P.o. Box 12622 Belfast ME 04915-4017 |
| Practice Telephone | 3019257610 |
| Mailing Telephone | 4434816580 |
| Mailing Fax Number | 4434816515 |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2014-06-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | D39421 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 116600000 | 05 | |
| RR MEDICARE | P01298022 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639604655 | Doreen Blake | Counselor | 733 2nd Avenue, Kotzebue, AK 99752-1453 | 2017-04-27 |
| Street Address |
1450 MERCANTILE LN SUITE 111 |
| City | LARGO |
| State | MD |
| Zip Code | 20774-5376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720070261 | David A Gooray | Internal Medicine | 1450 Mercantile Ln, Suite 217, Largo, MD 20774-5376 | 2005-08-19 |
| 1497287361 | Holistic Health & Wellness Medical Spa | Physical Therapist | 1450 Mercantile Ln, 221, Largo, MD 20774-5376 | 2017-03-30 |
| 1831640465 | Anne Arundel Physician Group LLC | Dietitian, Registered | 1450 Mercantile Ln, Suite 111, Largo, MD 20774-5376 | 2016-10-19 |
| 1427505825 | Holistic Health and Wellness Medical Spa | Nurse Practitioner | 1450 Mercantile Ln, Suite 221, Largo, MD 20774-5376 | 2016-09-02 |
| 1972903201 | Heritage Pediatrics, Inc. | Pediatrics | 1450 Mercantile Ln, Suite #217, Largo, MD 20774-5376 | 2014-08-22 |
| 1316372931 | Anne Arundel Physician Group, LLC | Internal Medicine | 1450 Mercantile Ln, Suite 111, Largo, MD 20774-5376 | 2013-09-13 |
| 1679821458 | Meetu Agrawal | Internal Medicine | 1450 Mercantile Ln, Suite 111, Largo, MD 20774-5376 | 2012-08-27 |
| 1316232135 | Jatin R Matta | Physician Assistant | 1450 Mercantile Ln, Suite 217, Largo, MD 20774-5376 | 2011-06-09 |
| 1750696779 | Susan E Jenkins, M.d.p.a. | Obstetrics & Gynecology | 1450 Mercantile Ln, Suite 117, Largo, MD 20774-5376 | 2010-08-13 |
| 1922249200 | Lisa V. Thompson, Dds, LLC | Clinic/Center | 1450 Mercantile Ln, Suite 207a, Largo, MD 20774-5376 | 2009-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922637156 | Marie Charlotte Teboutsou Tsodzou | Nurse Practitioner | 9317 Lavall Drive, Upper Marlboro, MD 20774 | 2020-04-08 |
| 1467093443 | Richland Support Services Corp. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11551 Joyceton Drive, Upper Marlboro, MD 20774 | 2019-10-01 |
| 1770134124 | Alan L Kahn | Counselor | 301 Largo Rd., Largo, MD 20774 | 2019-09-26 |
| 1619522034 | Francisca Ifeoma Alintah | Registered Nurse | 511 Dennis Magruder Dr., Upper Marlboro, MD 20774 | 2019-08-02 |
| 1609337146 | Crystal Osuchukwu | Counselor | 1300 Mccormick Dr, Upper Marlboro, MD 20774 | 2019-03-27 |
| 1861968489 | Collaborative Concepts of Maryland | Counselor | 1400 Mercantile Lane, Suite 208, Largo, MD 20774 | 2018-10-22 |
| 1073097622 | Triple Angels Homecare Services, Inc. | In Home Supportive Care | 1210 Dixie Bowie Way, Upper Marlboro, MD 20774 | 2018-09-19 |
| 1922589654 | Optimum Resource Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 711 Harry S. Truman Dr, Unit #105, Largo, MD 20774 | 2018-08-21 |
| 1811475254 | Kolawole Richard Olatunde | Home Health Aide | 11405 Villa Court, Upper Marlboro, MD 20774 | 2018-07-28 |
| 1548747769 | Tiara Williams | Counselor | 15207 Harriet Clotilda Way, Upper Marlboro, MD 20774 | 2018-07-20 |
| Find all providers in zip 20774 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720686843 | Bay Area Ipa, LLC | Internal Medicine | 8911 Silverthorn Rd, Largo, FL 33777-3170 | 2020-10-12 |
| 1265058622 | Largo Clinic LLC | Internal Medicine | 10500 Ulmerton Rd Ste 360, Largo, FL 33771-3504 | 2020-06-22 |
| 1407239627 | Charmaine Lamsin | Internal Medicine | 10309 Myrtle Oak Ln, Largo, FL 33777-1173 | 2015-07-07 |
| 1891101093 | Mariya Milko | Internal Medicine | 13220 Belcher Rd S Unit 1, Largo, FL 33773-1677 | 2014-07-08 |
| 1942548557 | Richard David Fournier | Internal Medicine | 1001 Starkey Rd Lot 446, Largo, FL 33771-5464 | 2013-01-17 |
| 1881942779 | Legacy Health Medical Group, LLC | Internal Medicine | 3500 Oak Manor Ln # 46, Largo, FL 33774-1211 | 2012-08-27 |
| 1699047472 | Arpit V Patel | Internal Medicine | 13220 Starkey Rd Ste 200, Largo, FL 33773-1445 | 2012-02-08 |
| 1922376847 | Michael R Nicoula | Internal Medicine | 1345 West Bay Dirve, Suite 202, Largo, FL 33770-2276 | 2011-12-06 |
| 1306073689 | Melissa Cristina Martinez | Internal Medicine | 10500 Ulmerton Rd # 202, Largo, FL 33771-3544 | 2009-06-15 |
| 1588813919 | Kathleen Evelyn Schuster | Internal Medicine | 12921 126th Ter, Largo, FL 33774-2607 | 2008-09-10 |
| Find all providers in LARGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.