Provider Demographics
NPI:1285375071
Name:CHRISTENSEN, BLAKE WADE (DO)
Entity type:Individual
Prefix:
First Name:BLAKE
Middle Name:WADE
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2451 UNIVERSITY HOSPITAL DR STE 212
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36617-2300
Mailing Address - Country:US
Mailing Address - Phone:251-434-3475
Mailing Address - Fax:251-434-3837
Practice Address - Street 1:2451 UNIVERSITY HOSPITAL DR STE 212
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-2300
Practice Address - Country:US
Practice Address - Phone:251-434-3475
Practice Address - Fax:251-434-3837
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL4126207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine