Individual
MARGARET FUNCH BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
9501187
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1179Y
BCBS
—
05
—
2004795000
—
WV
01
—
27001
PARTNERS
—
01
—
50086122
RR MEDICARE
—
05
—
5713579
—
VA
01
—
7355796
AETNA
—
01
—
84909
MEDCOST
—
05
—
891179Y
—
NC
05
—
Q0118D
—
SC
Enumeration date
12/13/2005
Last updated
06/28/2010
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