# PETER K BLACK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1265460406
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | MD61439872 | WA | — |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | MD24481 | OR | — |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | MD61439872 | WA | Yes |

## Other

- **Enumeration date:** 06/28/2006
- **Last updated:** 06/26/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 227426 | — | OR |
| 01 | — | P00464800 | RR MEDICARE | OR |