Provider Demographics
NPI:1760433718
Name:BLOCK, RONALD M (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:M
Last Name:BLOCK
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 1:16 E WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-2913
Mailing Address - Country:US
Mailing Address - Phone:610-543-1881
Mailing Address - Fax:
Practice Address - Street 1:16 E WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-2913
Practice Address - Country:US
Practice Address - Phone:610-543-1881
Practice Address - Fax:610-543-8711
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2017-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030028E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist