Provider Demographics
NPI:1003810094
Name:BLOCK, PAUL J (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:BLOCK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:340 MAIN ST
Mailing Address - Street 2:STE 670
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1604
Mailing Address - Country:US
Mailing Address - Phone:508-754-3566
Mailing Address - Fax:508-438-6368
Practice Address - Street 1:100 HOSPITAL RD
Practice Address - Street 2:STE 3A
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2253
Practice Address - Country:US
Practice Address - Phone:978-537-9305
Practice Address - Fax:978-537-9307
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2011-12-06
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Provider Licenses
StateLicense IDTaxonomies
MA44146207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6174884Medicaid
MAJ02906Medicare ID - Type Unspecified
MA6174884Medicaid