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Individual

ROBERT M BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
123 SUMMER STREET, SUITE 380 N, WORCESTOR, MA 01608
(508) 363-6126
(508) 363-9266
Mailing address
123 SUMMER ST, WORCESTER, MA 01608-1216
(508) 363-6126
(508) 363-9266

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
42763
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
042472266
ONE HEALTH PLAN
01
202138
CIGNA HEALTH PLAN
01
2071908
MEDICAID WELFARE
05
2071908
MA
01
26773
HEALTHY START
01
3100051
EVERCARE
01
7763607
US HEALTHCARE
01
783998
MVP HEALTH CARE
01
9900140
FALLON COMM HEALTH PLAN
01
AA2834
HARVARD PILGRAM HLTH CARE
01
B18224
BLUE CARE ELECT
Enumeration date
05/16/2006
Last updated
06/23/2020
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