Individual
DR. CALLIE G. BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10400 E ALAMEDA AVE, DENVER, CO 80247-5104
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
DR.0042742
CO
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
42742
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017648
KAISER COMMERCIAL NUMBER
CO
05
—
86471767
—
CO
Enumeration date
10/25/2006
Last updated
06/17/2021
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