Individual
GREGORY A BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
4913 HARROUN RD, SYLVANIA, OH 43560-2197
(419) 885-4471
(419) 885-0212
Mailing address
4913 HARROUN RD, SYLVANIA, OH 43560-2197
(419) 885-4471
(419) 885-0212
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
36002260
OH
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36.002260
OH
Other
Enumeration date
05/24/2005
Last updated
10/03/2022
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