Healthcare Provider Details
I. General information
NPI: 1225061385
Provider Name (Legal Business Name): BLOCK MEDICAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/09/2006
Last Update Date: 11/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
385 WILLIAM PITT WAY
PITTSBURGH PA
15238-1329
US
IV. Provider business mailing address
385 WILLIAM PITT WAY
PITTSBURGH PA
15238-1329
US
V. Phone/Fax
- Phone: 412-826-9380
- Fax: 412-826-9590
- Phone: 412-826-9380
- Fax: 412-826-9590
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0008X |
| Taxonomy | Hepatology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GEOFFREY
DOUGLAS
BLOCK
Title or Position: PRESIDENT
Credential: MD
Phone: 412-826-9380