Individual
DR. RICHARD R BLACK
Active
Individual
DR. RICHARD R BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34003488
OH
207U00000X
Nuclear Medicine Physician
Primary
34003488
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019707330001
—
PA
05
—
0834262
—
OH
01
—
3312151 00
MEDICAID PTAN
MD
05
—
8470726
—
WA
01
—
BL4212094
MEDICARE PTAN
OH
Enumeration date
11/28/2005
Last updated
01/27/2023
Update your record
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