Dr. Michael Clarence Blake, M.D.
Dr. Michael Clarence Blake is a Surgery Physician provider (Surgery) practicing in Suffolk, VA, registered in the NPPES registry with NPI 1063474955 since 2006. The credential MD stands for Doctor of Medicine.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1063474955 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Dr. Michael Clarence Blake |
| Credential | M.D. |
| Sex | Male |
| Practice address | 2790 GODWIN BLVD, STE 305, Suffolk, VA, 23434 |
| Phone | 7579344222 |
| Fax | 7579344111 |
| Enumeration date | 2006-04-05 |
| Last updated in NPPES | 2012-11-13 |
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 208600000X | Surgery Physician | Primary | 0101023774 | VA |
MD — Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential
Copy-ready billing details
Provider: Michael Blake, M.D. NPI: 1063474955 Taxonomy: 208600000X (Surgery Physician) Address: 2790 GODWIN BLVD, STE 305, Suffolk, VA, 23434
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1710970017 | Victor Archie | Individual | Radiation Oncology Physician | Suffolk, VA |
| 1902895899 | Stanley Smith | Individual | Nephrology Physician | Suffolk, VA |
| 1467533109 | Ear,Nose&Throat of Tidewater Inc | Organization | Otolaryngology Physician | Suffolk, VA |
| 1174691893 | Richard Kaye | Individual | Psychiatry Physician | Suffolk, VA |
| 1649334343 | Howard Harris | Individual | Vascular Surgery Physician | Suffolk, VA |
| 1821133174 | Mid-Atlantic Womens Care Plc | Organization | Obstetrics & Gynecology Physician | Suffolk, VA |
| 1477677748 | Richard A. Kaye, D.O. | Organization | Psychiatry Physician | Suffolk, VA |
| 1730389859 | Surgical Specialties, Inc. | Organization | Vascular Surgery Physician | Suffolk, VA |
Verify this record
Cross-check NPI 1063474955 against the authoritative CMS record: view Dr. Michael Clarence Blake on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Is NPI 1063474955 active?
How do I verify Michael Blake's NPI record?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2012-11-13.