Blake Andrew Wareham
Blake Andrew Wareham is a Physician Assistant in Milwaukee, Wisconsin. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in Illinois.
- Years since qualifying
- 1
- Licensed in
- IL
- In the registry since
- 2025
Practice location Address checks out
507 N 17th StMilwaukee, WI 53233-2104
Phone: (414) 288-5688
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Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence 085.011867 (IL) |
|---|
Record details
| NPI number | 1518855907 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | June 25, 2025 |
| Last updated in NPPES | February 25, 2026 |
| Certification date | February 25, 2026 |
| Mailing address | 507 N 17th St, Milwaukee, WI 53233-2104 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2025 (1 years in practice) |
| Accepts Medicare assignment | Not indicated |
| Practice locations | 3 on file with Medicare |
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