Individual
DR. CARRIE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3000 Q ST, SACRAMENTO, CA 95816-7058
(916) 733-3331
(916) 733-3307
Mailing address
3400 DATA DR, PHYSICIAN SUPPORT SERVICES, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
136371
CA
208600000X
Surgery Physician
52158-020
WI
208600000X
Surgery Physician
EC071020
ME
Other
Enumeration date
07/12/2007
Last updated
07/08/2015
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