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Individual

IRA G ROCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9263 MEDICAL PLAZA DR STE E, CHARLESTON, SC 29406-7112
(843) 572-1228
Mailing address
101 HARRIS RD, KILMARNOCK, VA 22482-3880
(804) 435-8000
(804) 435-8078

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
027439
CT
207L00000X
Anesthesiology Physician
Primary
84690
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001274398
CT
01
48F541
EMPIRE BC
NY
01
P00916913
MEDICARE RAILROAD
VA
Enumeration date
05/13/2006
Last updated
05/03/2021
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