Individual
DR. RYAN MADSEN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
28050 GRAND RIVER AVE, FARMINGTON HILLS, MI 48336-5919
(248) 471-8822
(248) 471-8837
Mailing address
527 S MOSS HILL DR, BOUNTIFUL, UT 84010-1429
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101019906
MI
Other
Enumeration date
06/05/2012
Last updated
06/05/2012
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