Organization
JAMES D BLACK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES D BLACK DPM (PODIATRIST/OWNER)
(313) 882-7480
Entity
Organization
Contact information
Practice address
18010 MACK AVE, GROSSE POINTE, MI 48230-6235
(313) 882-7480
(248) 652-3401
Mailing address
18010 MACK AVE, GROSSE POINTE, MI 48230-6235
(313) 882-7480
(313) 882-7525
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
JB001105
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
485635035
BCBSM
MI
01
—
5635035
PTAN
MI
Enumeration date
02/14/2008
Last updated
08/28/2019
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