MEDICARE: DR. DANIEL BARRY BLOCK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	MD045021L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MD045021L	OTHER	PA	PA LICENSE

General Provider Information

NPI Number	:	1578561965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL BARRY BLOCK MD

Provider Business Mailing Address
First Line	:	227 E EVERGREEN ST
Second Line	:
City	:	WEST GROVE
State	:	PA
Zip	:	19390-1037
Country	:	US
Telephone Number	:	610-869-1453
Fax Number	:	610-869-6293

Provider Business Practice Location Address
First Line	:	227 E EVERGREEN ST
Second Line	:
City	:	WEST GROVE
State	:	PA
Zip	:	19390-1037
Country	:	US
Telephone Number	:	610-869-1453
Fax Number	:	610-869-6293

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	07/08/2007

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