Healthcare Provider Details

I. General information

NPI: 1841262110
Provider Name (Legal Business Name): ALLAN M BLOCK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 12/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10210 N 92ND ST SUITE 202
SCOTTSDALE AZ
85258-4509
US

IV. Provider business mailing address

PO BOX 27340
PHOENIX AZ
85061-7340
US

V. Phone/Fax

Practice location:
  • Phone: 480-314-5460
  • Fax: 480-451-6769
Mailing address:
  • Phone: 602-943-9200
  • Fax: 602-216-3000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25135
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: