Provider Demographics
NPI:1710570080
Name:ROBERT DOCK DO PC
Entity Type:Organization
Organization Name:ROBERT DOCK DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:DOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-855-1311
Mailing Address - Street 1:28202 HARWICH DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3204
Mailing Address - Country:US
Mailing Address - Phone:248-855-1311
Mailing Address - Fax:
Practice Address - Street 1:28202 HARWICH DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3204
Practice Address - Country:US
Practice Address - Phone:248-855-1311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty