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

Dr. Michael Clarence Blake, MD

Individual provider Surgery Physician · NPI 1063474955

Dr. Michael Clarence Blake, MD is a Surgery Physician in Suffolk, Virginia. Licensed in Virginia. Registered with an NPI since 2006.

Licensed in
VA
In the registry since
2006
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

2790 Godwin Blvd Ste 305
Suffolk, VA 23434-8151
Phone: (757) 934-4222
Fax: (757) 934-4111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 0101023774 (VA)

Record details

NPI number1063474955
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 5, 2006
Last updated in NPPESNovember 13, 2012
Mailing address2790 Godwin Blvd, Ste 305, Suffolk, VA 23434-8151

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