Individual
KRISTIN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2601 CRANBERRY SQ, MORGANTOWN, WV 26508-9201
(304) 285-1702
(304) 285-1918
Mailing address
527 MEDICAL PARK DR, STE 500, BRIDGEPORT, WV 26330-9008
(681) 342-3600
(681) 342-3625
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
3370
WV
207Q00000X
Family Medicine Physician
Primary
3370
WV
Other
Enumeration date
05/04/2016
Last updated
03/14/2024
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