Provider Demographics
NPI:1699753756
Name:BLOCK, DAVID ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALAN
Last Name:BLOCK
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1314 VINCENT PL
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3614
Mailing Address - Country:US
Mailing Address - Phone:703-821-8128
Mailing Address - Fax:703-821-5076
Practice Address - Street 1:1314 VINCENT PL
Practice Address - Street 2:SUITE 1
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3614
Practice Address - Country:US
Practice Address - Phone:703-821-8128
Practice Address - Fax:703-821-5076
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-08
Last Update Date:2010-07-09
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Provider Licenses
StateLicense IDTaxonomies
VA01010257072084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
C62518Medicare UPIN