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Individual
MARA BLACK
Active
Individual
MARA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
D94025
MD
207VM0101X
Maternal & Fetal Medicine Physician
Primary
042.0040390
VT
Other
Enumeration date
04/13/2018
Last updated
08/10/2026
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