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

Ethan Jeffrey Blake, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1538854302

Ethan Jeffrey Blake, MD is a Student in an Organized Health Care Education/Training Program in Indianapolis, Indiana. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone: (317) 944-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1538854302
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 7, 2023
Last updated in NPPESApril 7, 2023
Certification dateApril 7, 2023

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