MEDICARE: DR. DEBRA M BLOCK D.C.

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	111N00000X	Chiropractor	02149	MD
2	111NR0400X	Rehabilitation Chiropractor	02149	MD

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	41519201	OTHER	MD	BCBS RENDERING #

General Provider Information

NPI Number	:	1750500864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBRA M BLOCK D.C.

Provider Business Mailing Address
First Line	:	3919 NATIONAL DR
Second Line	:	SUITE 110
City	:	BURTONSVILLE
State	:	MD
Zip	:	20866-1105
Country	:	US
Telephone Number	:	301-476-7575
Fax Number	:	301-476-7730

Provider Business Practice Location Address
First Line	:	3919 NATIONAL DR
Second Line	:	SUITE 110
City	:	BURTONSVILLE
State	:	MD
Zip	:	20866-1105
Country	:	US
Telephone Number	:	301-476-7575
Fax Number	:	301-476-7730

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

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	02/21/2014

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