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General NPI Number Information
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NPI Number | 1972734317
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Entity Type | Organization
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Legal Business Name | MARTIN I. SCHOCK, MD PC
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Dates
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Enumeration Date | 08/03/2009
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Last Update Date | 08/03/2009
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Provider Practice Location Address
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Address Line | 31700 VAN DYKE AVE SUITE 110
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City | WARREN
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State | MI
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Zip | 48093-7949
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Country | US
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Telephone | 586-276-8131
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Fax | 586-276-8101
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Provider Business Mailing Address
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Address Line | 6039 HICKORY TREE TRL
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48301-1341
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Country | US
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Telephone | 586-276-8131
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Fax | 586-276-8101
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARTIN IRVIN SCHOCK
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Credential | M.D.
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Telephone | 586-276-8131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0200X
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Taxonomy Name | Oncology Clinic/Center
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License Number | 4301027896
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License Number State | MI
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