Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 44146 | MA |
N | 111NI0900X | Internist | 44146 | MA |
Y | 207RC0000X | Internist - Cardiovascular Disease | 44146 | MA |
NPI | 1003810094 |
---|---|
Provider Name | Paul J Block |
First Address | Worcester, MA 01608-1604 |
Second Address | Leominster, MA 01453-2253 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 06/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6174884 | (05) | MA |
B99167 | (02) | MA |