Individual
JAMES R BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301046513
MI
208000000X
Pediatrics Physician
Primary
4301046513
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010C17613
BLUE CROSS
MI
05
—
2646217
—
MI
Enumeration date
11/30/2006
Last updated
09/19/2025
Update your record
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