Individual
DR. BRENTON L BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 PEACHTREE ST NE FL 7, ATLANTA, GA 30308-2247
(404) 686-8181
(404) 686-5905
Mailing address
550 PEACHTREE ST NE FL 7, ATLANTA, GA 30308-2247
(404) 686-8181
(404) 686-5905
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
059126
GA
Other
Enumeration date
05/10/2007
Last updated
10/11/2012
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