Individual
ERIC BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
431 MEADOWLARK ST, SHAW AFB, SC 29152-5019
(803) 895-2273
Mailing address
431 MEADOWLARK ST, SHAW AFB, SC 29152-5019
(803) 895-2273
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
10/27/2021
Last updated
10/27/2021
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