Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 36777 | OH |
N | 2080P0205X | Pediatric Endocrinologist | 000500 | OH |
NPI | 1003914490 |
---|---|
Provider Name | Dr. Clifford A Bloch |
First Address | Greenwood Village, CO 80111 |
Second Address | Greenwood Village, CO 80111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01283100 | (05) | CO |
BM7598470 | DEA (01) | |
I28091 | (02) |