Individual
DAVID G. BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
900 WALNUT ST, 2ND FLOOR, PHILADELPHIA, PA 19107-5509
(215) 955-1234
(215) 923-3504
Mailing address
615 CHESTNUT ST, 14TH FLOOR, CENTRAL ENROLLMENT, PHILADELPHIA, PA 19106-4404
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD-059703-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001600151
—
PA
05
—
6527108
—
NJ
Enumeration date
07/25/2006
Last updated
03/01/2011
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