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Organization

MAIN STREET FAMILY MEDICINE P C

Active
Other names
Main Center Family Medicine
Organization subpart
No

Provider details

NPI number
Authorized official
NATHAN J BLOCH DO (CEO)
(248) 348-1131
Entity
Organization

Contact information

Practice address
422 N CENTER ST, NORTHVILLE, MI 48167-1224
(248) 348-1131
(248) 348-1170
Mailing address
422 N CENTER ST, NORTHVILLE, MI 48167-1224
(248) 348-1131
(248) 348-1170

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4118116
MI
01
CG4894
MEDICARE RAILROAD PIN
MI
Enumeration date
01/30/2007
Last updated
11/12/2009
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