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General NPI Number Information
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NPI Number | 1780728188
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Entity Type | Individual
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Provider Name | JOANNA M. BOCK M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/18/2007
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Last Update Date | 12/01/2015
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Provider Practice Location Address
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Address Line | 41816 FENWAY CIR
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City | ASHBURN
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State | VA
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Zip | 20148-8069
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Country | US
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Telephone | 347-761-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 41816 FENWAY CIR
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City | ASHBURN
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State | VA
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Zip | 20148-8069
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Country | US
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Telephone | 347-761-7200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME116776
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101259225
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License Number State | VA
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