Individual
DR. JENNA E BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 442-1100
Mailing address
2520 INDEPENDENCE BLVD STE 200, WILMINGTON, NC 28412-2482
(910) 442-1100
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
400640
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8913699
—
NC
Enumeration date
05/16/2006
Last updated
08/14/2013
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