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Individual

TERRY N BLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1401 13TH AVE E, WEST FARGO, ND 58078-3468
(701) 364-0060
(701) 364-0065
Mailing address
1401 13TH AVE E, WEST FARGO, ND 58078-3468
(701) 364-0060
(701) 364-0065

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
5960
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10284
NDBS #
ND
05
16448
ND
01
28948BL
MNBS #
ND
05
726802500
ND
01
HP22978
HEALTHPARTNERS #
ND
Enumeration date
07/08/2006
Last updated
05/04/2010
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