Provider Demographics
NPI:1245438597
Name:BLAKE, HELEN MAUREEN (MD)
Entity type:Individual
Prefix:DR
First Name:HELEN
Middle Name:MAUREEN
Last Name:BLAKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14825 NORTH OUTER 40 RD STE 360
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-2108
Mailing Address - Country:US
Mailing Address - Phone:314-336-2570
Mailing Address - Fax:314-336-2571
Practice Address - Street 1:14825 NORTH OUTER 40 RD STE 360
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2108
Practice Address - Country:US
Practice Address - Phone:314-336-2570
Practice Address - Fax:314-336-2571
Is Sole Proprietor?:No
Enumeration Date:2007-07-09
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007016653207L00000X, 390200000X
NY260816207LP2900X
MO2012021214208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program