Individual
DR. DEBORAH NAOMI BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
130 FISHER RD, MOB-A SUITE 1, BERLIN, VT 05602-9516
(802) 225-5650
(802) 225-5651
Mailing address
PO BOX 547, ATT: CVMC FINANCE DEPT, BARRE, VT 05641-0547
(802) 225-5650
(802) 225-5651
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
042 0009704
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OVN1845
—
VT
01
—
VN184503
MEDICARE PTAN LINKED TO CVMC
VT
Enumeration date
02/05/2007
Last updated
01/14/2015
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