Individual
DR. SAMANTHA GWEN BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-3898
Mailing address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-3898
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01083831A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Enumeration date
04/10/2018
Last updated
08/12/2026
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