Provider Demographics
NPI:1003914490
Name:BLOCH, CLIFFORD A (MD)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:A
Last Name:BLOCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 E BELLEVIEW AVE
Mailing Address - Street 2:#510E
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111
Mailing Address - Country:US
Mailing Address - Phone:303-783-3883
Mailing Address - Fax:303-783-3800
Practice Address - Street 1:8200 E BELLEVIEW AVE
Practice Address - Street 2:#510E
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111
Practice Address - Country:US
Practice Address - Phone:303-783-3883
Practice Address - Fax:303-783-3800
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36777208000000X
OH0005002080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01283100Medicaid
CO01283100Medicaid
I28091Medicare UPIN
CO01283100Medicaid