Dr. Randall Bock
Family Doctor - Adult Medicine
372 Broadway Medical Treatment Center Of Revere
Revere
, Massachusetts 02151-5016
Dr. Randall Bock
Family Doctor - Adult Medicine
372 Broadway Medical Treatment Center Of Revere
Revere
, Massachusetts 02151-5016
(781) 289-3076
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About
Features
Specialties
- Family Doctor - Adult Medicine
Languages spoken
- English
Location
First Address
- Dr. Randall Bock
- 372 Broadway Medical Treatment Center Of Revere
- Revere, MA
- Zip : 02151-5016
- Fax : (781) 289-3076
- Phone : (781) 286-3000
Second Address
- Dr. Randall Bock
- 372 Broadway Medical Treatment Center Of Revere
- Revere, MA
- Zip : 02151-5016
- Fax : (781) 289-3076
- Phone : (781) 286-3000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QA0505X | Family Doctor - Adult Medicine | 51810 | MA |
National Provider Identifier
| NPI | 1205991031 |
|---|---|
| Provider Name | Dr. Randall Bock |
| First Address | Revere, MA 02151-5016 |
| Second Address | Revere, MA 02151-5016 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/12/2006 |
| Last Update Date | 09/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 6199682 | (05) | MA |
| B87158 | (02) | MA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.