Provider Demographics
NPI:1588652895
Name:BLOCK, MARIAN R (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIAN
Middle Name:R
Last Name:BLOCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5889 FORBES AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1660
Mailing Address - Country:US
Mailing Address - Phone:412-421-3500
Mailing Address - Fax:412-421-3528
Practice Address - Street 1:5889 FORBES AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1660
Practice Address - Country:US
Practice Address - Phone:412-421-3500
Practice Address - Fax:412-421-3528
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD013948E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007999410004Medicaid
PA0007999410004Medicaid
PA40011R7RMedicare PIN
PAP00465743Medicare PIN