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

Dr. Donnevan Blake, MD

Individual provider Cardiovascular Disease Physician · NPI 1801854898

Dr. Donnevan Blake, MD is a Cardiovascular Disease (Cardiology) in Green Bay, Wisconsin. Graduated from University of Cincinnati College of Medicine in 2003, 23 years ago. Practices with Oconto Hospital and Medical Center Inc, a 217-clinician group and accepts Medicare assignment. Licensed in Michigan and Wisconsin.

Years since qualifying
23
Trained at
University of Cincinnati College of Medicine
Licensed in
MI, WI
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

744 S Webster Ave Fl 2
Green Bay, WI 54301-3505
Phone: (920) 433-3640
Fax: (920) 433-3716
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Cardiovascular Disease Physician (primary) Taxonomy 207RC0000X · Licence 52766-20 (WI)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 4301095491 (MI)

Record details

NPI number1801854898
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 2, 2006
Last updated in NPPESJuly 7, 2011
Mailing address744 S Webster Ave Fl 2, Green Bay, WI 54301-3505

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCARDIOVASCULAR DISEASE (CARDIOLOGY)
Also practisesINTERNAL MEDICINE
Medical schoolUNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduated 2003 (23 years in practice)
Group practice Oconto Hospital And Medical Center Inc — 217 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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