Individual
MITCHELL C. BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3643 N ROXBORO ST, DURHAM, NC 27704-2702
(919) 470-8490
Mailing address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 970-4175
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2010-00846
NC
390200000X
Student in an Organized Health Care Education/Training Program
142044
NC
Other
Enumeration date
05/19/2008
Last updated
05/24/2010
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