Individual
KATHERINE A. BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
78 MEDICAL CENTER DR, FISHERSVILLE, VA 22939-2332
(540) 332-5757
(540) 332-5756
Mailing address
PO BOX 388, FISHERSVILLE, VA 22939-0388
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101250011
VA
207L00000X
Anesthesiology Physician
60825
WI
207LP2900X
Pain Medicine (Anesthesiology) Physician
0101250011
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033315551
—
WI
Enumeration date
06/22/2007
Last updated
07/25/2024
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