| Doctor Name: | DR. PETR BOCEK |
| NPI Number: | 1790998458 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD, PHD |
| License Number: | D0061993 |
| Business Practice Address: | 8100 Ashton Avenue Suite 207b Manassas, VA - 20109 |
| Business Phone Number: | 8555287348 |
| Business Fax Number: | 8553292873 |
| Mailing Address: | P.o. Box 348, POOLESVILLE |
| State: | MD |
| Postal Code: | 20837 |
| Phone Number: | 8555287348 |
| Fax Number: | 8553292873 |
| NPI Enumeration Date: | 05/08/2007 |
| NPI Last Update Date: | 01/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | D0061993 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |