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Individual
RICHARD BLACK
Active
Individual
RICHARD BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
71590
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110051363A
—
MA
05
—
3093158
—
MA
Enumeration date
08/09/2005
Last updated
11/27/2018
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