Provider Demographics
NPI:1215548540
Name:BUEHRER, BLAKE FREDERICK (PA)
Entity type:Individual
Prefix:MR
First Name:BLAKE
Middle Name:FREDERICK
Last Name:BUEHRER
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-362-9123
Mailing Address - Fax:314-747-9160
Practice Address - Street 1:1225 GRAHAM RD
Practice Address - Street 2:DEPT EMERGENCY MEDICINE
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-8012
Practice Address - Country:US
Practice Address - Phone:314-362-9123
Practice Address - Fax:314-747-9160
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2025-07-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2022004072363A00000X
IL085010170363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant