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Individual

WILLIAM L BLACK

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
40 HOLLAND ST, INTERNAL MEDICINE, SOMERVILLE, MA 02144-2705
(617) 629-6000
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8374
(617) 421-3487

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
44271
MA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
44271
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
044271
TUFTS
MA
05
2096129
MA
01
E05162
BLUE CROSS
MA
01
PV509
HARVARD PILGRIM
MA
Enumeration date
01/27/2006
Last updated
09/11/2025
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