Individual
SAMUEL BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2401 W BELVEDERE AVE, BALTIMORE, MD 21215-5216
(410) 601-0594
(410) 601-0939
Mailing address
2401 W BELVEDERE AVE, BALTIMORE, MD 21215-5216
(410) 601-0594
(410) 601-0939
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D0087167
MD
207R00000X
Internal Medicine Physician
Primary
D87167
MD
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
03/30/2016
Last updated
04/22/2025
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