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Individual
DR. ANTHONY SHANE BLACK
Active
Individual
DR. ANTHONY SHANE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1638
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497724645
NPI
AL
01
—
350045914
RAILROAD MEDICARE PALMETTO
AL
01
—
51078506
BLUE CROSS BLUE SHIELD
AL
Enumeration date
03/17/2006
Last updated
09/09/2013
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