Individual
FREDRIC LEE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1000 SOUTH COLUMBIA ROAD, GRAND FORKS, ND 58206-6002
(701) 780-5000
(701) 780-1942
Mailing address
PO BOX 6002, GRAND FORKS, ND 58206-6002
(701) 780-5000
(701) 780-1942
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7575
ND
Other
Enumeration date
09/20/2006
Last updated
12/28/2007
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