Individual
DR. EVAN GEORGE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5323 WOODROW ST, #201, MURRAY, UT 84107-5841
(801) 261-4711
(801) 261-4769
Mailing address
5323 WOODROW ST, #201, MURRAY, UT 84107-5841
(801) 261-4711
(801) 261-4769
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
187597-1205
UT
2084N0400X
Neurology Physician
21619
NH
2084N0400X
Neurology Physician
89191
GA
2084N0400X
Neurology Physician
99622
MT
2084N0400X
Neurology Physician
Primary
MD205738
OR
2084N0400X
Neurology Physician
MD476184
PA
Other
Enumeration date
07/20/2006
Last updated
01/03/2023
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