Organization
RANDALL BOCK MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL S BOCK M D (DIRECTOR)
(617) 982-2865
Entity
Organization
Contact information
Practice address
1660 SOLDIERS FIELD RD # 1021, BRIGHTON, MA 02135-1108
(617) 901-4847
(781) 286-3076
Mailing address
1660 SOLDIERS FIELD RD # 1021, BRIGHTON, MA 02135-1108
(617) 982-2865
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
51810
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6199682
—
MA
01
—
J04222
BLUE CROSS BLUE SHIELD
MA
Enumeration date
06/04/2008
Last updated
01/26/2023
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