Individual
SHAUN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
201 STATE ST, ERIE, PA 16550-0002
(814) 877-6139
Mailing address
201 STATE ST, ERIE, PA 16550-0002
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS015075
PA
Other
Enumeration date
06/12/2008
Last updated
01/31/2023
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