Individual
EDWARD BARNWELL BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1705 EAST BLVD, CHARLOTTE, NC 28203-5800
(704) 909-5960
(704) 770-0501
Mailing address
1705 EAST BLVD, CHARLOTTE, NC 28203-5800
(704) 909-5960
(704) 770-0501
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
22677
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7915850
—
NC
Enumeration date
06/15/2005
Last updated
05/28/2014
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