Individual
SUSAN ANN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1504 GALENA ST, AURORA, CO 80010-2219
(303) 617-2300
Mailing address
1290 CHAMBERS RD, AURORA, CO 80011-7117
(303) 617-2300
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
29718
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01297183
—
CO
Enumeration date
12/22/2006
Last updated
12/15/2022
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