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Dr. Diane R Blake, MD
Pediatric Adolescent Medicine Physician in Worcester, Massachusetts
NPI 1316921182

Diane R Blake is a Pediatric Adolescent Medicine Physician based in Shrewsbury, MA and is specialized in Adolescent Medicine. Diane R Blake practices in Worcester, MA and has the professional credentials of MD. The NPI Number for Diane R Blake is 1316921182 and holds a License No. 154470 (Massachusetts).

The current practice location address for Diane R Blake is 55 Lake Ave N, Worcester, MA and can be reached out via phone at 508-856-5624.

Location: 55 Lake Ave N, Worcester, MA, 01545-0062
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Provider Profile Details
NPI Number
1316921182
Provider Name
Diane R Blake
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
55 Lake Ave N, Worcester, MA, 01545-0062
Phone Number
508-856-5624
Fax Number
Provider Enumeration Date
12/05/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3169863 05 MA
institution
Provider Business Practice Location Address Details
Address
55 Lake Ave N
City
State
Zip
01655-0002
Phone Number
508-856-5624
Fax Number
person
Provider Business Mailing Address Details
Address
55 Lake Ave N
City
State
Zip
01655-0002
Phone Number
508-856-5624
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Pediatrics
Speciality
Adolescent Medicine
Taxonomy
License No.
154470 (Massachusetts)
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
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