Individual
DAVID MICHAEL BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
625 9TH AVE, STE 210, LONGVIEW, WA 98632-2465
(360) 501-3400
(360) 423-6862
Mailing address
625 9TH AVE, STE 210, LONGVIEW, WA 98632-2465
(360) 501-3400
(360) 423-6862
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MD00023497
WA
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
MD00024397
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014117
—
WA
05
—
178434
—
OR
Enumeration date
02/22/2006
Last updated
04/07/2014
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