Most Relevant Information
Provider Data
| NPI Number: | 1003293804 |
| Provider Name: | BLAKE ERVIN COLLISON MD |
| Entity Type: | Individual |
| Taxonomy Code: | 207P00000X |
| Specialty: | Emergency Medicine |
| License Number: | 63874 |
Most Important Dates
| Enumeration Date: | 04/30/2015 |
| Last Updated: | 06/22/2018 |
Provider Practice Location
407 E 3RD ST
DULUTH
MN
55805
Practice Location Phone/Fax
| Phone: | 2187864000 |
| Fax: |
Provider Mailing Location
1702 UNIVERSITY DR S
FARGO
ND
581034940
Provider Mailing Phone/Fax
| Phone: | 7013644222 |
| Fax: |