Individual
THOMAS BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14 RICHLAND MEDICAL PARK DR STE 320, COLUMBIA, SC 29203-6896
(803) 434-6771
(803) 434-3855
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
232292
NY
208000000X
Pediatrics Physician
Primary
86636
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026910201
UNIVERA HEALTHCARE
NY
01
—
00026910202
UNIVERA
—
01
—
000527733001
BLUE CROSS BLUE SHIELD
NY
01
—
000527733002
BC/BS
—
05
—
02577360
—
NY
01
—
070804000017
FIDELIS
—
01
—
1212594
IHA
—
Enumeration date
02/02/2006
Last updated
10/10/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us