Individual
WARREN BENJAMIN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
268 STILLWATER AVE, BANGOR, ME 04401-3945
(207) 973-6100
Mailing address
268 STILLWATER AVE, P.O. BOX 422, BANGOR, ME 04401-3945
(207) 973-6100
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP141098
ME
Other
Enumeration date
10/03/2014
Last updated
10/03/2014
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