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Individual

DR. STEVEN R BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
405 W COUNTRY CLUB RD, ROSWELL, NM 88201-5209
(575) 624-2095
(575) 208-0780
Mailing address
PO BOX 8244, ROSWELL, NM 88202-8244
(575) 624-2095
(575) 208-0780

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD2011-0547
NM
2084P0800X
Psychiatry Physician
Primary
MD2011-0547
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
66933862
NM
Enumeration date
11/23/2005
Last updated
11/04/2024
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