Individual
DEREK BLOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2770 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525-8614
(616) 267-8741
Mailing address
4100 LAKE DR SE STE 300, GRAND RAPIDS, MI 49546-8292
(616) 267-8741
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301119280
MI
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
4301119280
MI
Other
Enumeration date
06/30/2017
Last updated
11/05/2024
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