Individual
DR. TRACY M BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4220 N ROXBORO ST, DURHAM, NC 27704-1826
(919) 471-1518
Mailing address
5213 S ALSTON AVE, DURHAM, NC 27713-4430
(919) 620-4467
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
9400724
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12086
BCBS
NC
01
—
2337913
MEDICARE LEGACY ID
NC
01
—
4646370
AETNA
NC
05
—
8912086
—
NC
01
—
P00163549
RAILROAD
NC
Enumeration date
03/01/2006
Last updated
01/30/2013
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