Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Blake Anderson, DO

Individual provider Internal Medicine Physician · NPI 1063271641

Blake Anderson, DO is an Internal Medicine Physician in Saint Louis, Missouri. Practices as a sole proprietor and works from 2 locations. Licensed in Idaho.

Licensed in
ID
In the registry since
2024
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1402 S Grand Blvd # M260
Saint Louis, MO 63104-1004
Phone: (618) 210-5609
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3100 Channing Way, Idaho Falls, ID 83404-7533 — (208) 227-2850

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Internal Medicine Physician Taxonomy 207R00000X · Licence MRO-2400 (ID)

Record details

NPI number1063271641
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedMarch 18, 2024
Last updated in NPPESMarch 26, 2025
Certification dateMarch 26, 2025
Mailing address3100 Channing Way, Idaho Falls, ID 83404-7533

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