Individual provider · NPI-1

Daniel J. Brock, M.D.

Family Medicine · Mentor, OH

NPI number1285848614
StatusActive
Last updated in NPPESFeb 25, 2021

Details

NPI
1285848614
Entity type
Individual (NPI-1)
Name
Daniel J. Brock
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
May 8, 2007
Certification date
Feb 25, 2021
Last updated
Feb 25, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine35.090928OHYes

Practice location

8655 Market Street
Mentor, OH 44060

Phone 440-255-7938 · Fax 440-255-9196

Mailing address

P.O. Box 714328
Columbus, OH 43271-4328

Phone 440-255-7938 · Fax 440-255-9196

Other practice locations

6990 Lindsay Drive
Suite 3
Mentor, OH 44060

Phone 440-255-7938 · Fax 440-255-9196

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