Individual
MR. PAUL TALMAGE BROCK II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2100 ERWIN ROAD, DURHAM, NC 27705-3941
(919) 620-4917
(919) 620-4921
Mailing address
PO BOX 751274, CHARLOTTE, NC 28275-1274
(919) 620-4917
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209106
NC
Other
Enumeration date
08/05/2011
Last updated
08/05/2011
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