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NPI Code Detail

MEDICARE: DR. JARED G BLOCK M.D.

MEDICARE: DR. JARED G BLOCK M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZH0000XHematology (Pathology) Physician22138SC
2207ZP0102XAnatomic Pathology & Clinical Pathology Physician22138SC
3207ZP0102XAnatomic Pathology & Clinical Pathology Physician9900429NC
4207ZH0000XHematology (Pathology) Physician9900429NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629079140
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JARED G BLOCK M.D.
Provider Business Mailing Address
First Line : PO BOX 96782
Second Line :
City : CHARLOTTE
State : NC
Zip : 28296-6782
Country : US
Telephone Number : 704-973-5500
Fax Number :
Provider Business Practice Location Address
First Line : 10628 PARK RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-8407
Country : US
Telephone Number : 704-973-5500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 11/18/2024

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