Individual
MATTHEW D. BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 501-3601
(360) 501-3648
Mailing address
8614 SE 11TH AVE, PORTLAND, OR 97202-7012
(503) 915-9093
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD166695
OR
207R00000X
Internal Medicine Physician
Primary
MD60662849
WA
Other
Enumeration date
04/26/2010
Last updated
11/24/2020
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