Individual
DR. CHAD ROBINSON BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3131 LA CANADA ST STE 200, LAS VEGAS, NV 89169-2579
(702) 369-5582
(702) 369-8470
Mailing address
PO BOX 98978, LAS VEGAS, NV 89193-8978
(702) 216-3346
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20232
NV
207Q00000X
Family Medicine Physician
ME 100993
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013186964
—
NV
01
—
20232
STATE LICENSE
NV
01
—
ME100993
LICENSE
FL
Enumeration date
02/25/2008
Last updated
10/16/2024
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