Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 35-128854 | OH |
N | 2080P0202X | Pediatric Cardiologist | 4301076017 | MI |
NPI | 1134243371 |
---|---|
Provider Name | Martin Lindsey Bocks |
First Address | Highland Hills, OH 44122-7251 |
Second Address | Cleveland, OH 44106-1716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 14/12/2020 |