Healthcare Provider Details

I. General information

NPI: 1205755436
Provider Name (Legal Business Name): SAMANTHA MARIE BLOCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BANNING ST STE 320
DOVER DE
19904-3488
US

IV. Provider business mailing address

139 NETHERLANDS DR
MIDDLETOWN DE
19709-9679
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-0223
  • Fax:
Mailing address:
  • Phone: 302-383-1650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC5-0012492
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: