Individual
DR. LISA B BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
701 E MARSHALL ST STE 640, WEST CHESTER, PA 19380-4412
(610) 738-2709
Mailing address
701 E MARSHALL ST, STE 640, WEST CHESTR, PA 19380-4412
(610) 738-2709
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD059690L
PA
208M00000X
Hospitalist Physician
Primary
MD059690L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001653594
—
PA
01
—
232359401
MAIN LINE HEALTHCARE
PA
Enumeration date
02/10/2006
Last updated
07/21/2022
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