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Individual
MIKE A BLACK
Active
Individual
MIKE A BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CEPS, NREMT
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
E1160515
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
161255
DC
246W00000X
Cardiology Technician
60434882
WA
Other
Enumeration date
12/28/2017
Last updated
05/03/2019
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