Provider Demographics
NPI:1821036633
Name:BOCK, RICHARD W (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:W
Last Name:BOCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1091 HENDERSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1873
Mailing Address - Country:US
Mailing Address - Phone:828-210-7990
Mailing Address - Fax:828-210-7988
Practice Address - Street 1:1091 HENDERSONVILLE RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1873
Practice Address - Country:US
Practice Address - Phone:828-210-7990
Practice Address - Fax:828-210-7988
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9500837208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC16361OtherBCBS NC
NC1821036633Medicaid
NC16361OtherBCBS NC
NC2217527AMedicare PIN
NC2217527BMedicare PIN