Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 12677 | ND |
N | 208600000X | Surgeon | 12677 | ND |
N | 208200000X | Surgeon | MD00027549 | WA |
N | 208600000X | Surgeon | MD00027549 | WA |
Y | 208200000X | Surgeon | MD2015-0112 | NM |
Y | 208600000X | Surgeon | MD2015-0112 | NM |
N | 2086X0206X | Surgical Oncologist | MD00027549 | WA |
NPI | 1194850867 |
---|---|
Provider Name | Steven N Bock |
First Address | Albuquerque, NM 87106-4375 |
Second Address | Rio Rancho, NM 87144-2100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 01/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
17902 | (05) | ND |
8135741 | (05) | WA |
E27300 | (02) | WA |