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Individual

JAMES E BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
640 JACKSON ST, MAIL STOP 11302C, HEALTHPARTNERS REGIONS BEHAVIORAL HEA, ST. PAUL, MN 55101-2502
(651) 254-4786
(651) 254-9426
Mailing address
8170 33RD AVE S, MS21110Q, MINNEAPOLIS, MN 55425-4516

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
036-092041
IL
2084P0800X
Psychiatry Physician
Primary
54355
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036092041
IL
Enumeration date
03/10/2006
Last updated
03/12/2021
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