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Individual

BARBARA A BLACK

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
1821 FULTON ST, HARRISBURG, PA 17102-1522
(717) 232-9971
(717) 230-3914
Mailing address
109 LYNDHURST RD, YORK, PA 17402-3016
(717) 880-1318
(717) 741-5762

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC002964L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1175727
PA
01
562755
BLUE SHIELD
PA
Enumeration date
10/28/2005
Last updated
07/08/2007
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