Individual
MICHELLE T BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10700 E GEDDES AVE, SUITE 200, ENGLEWOOD, CO 80112-3800
(303) 761-9190
(720) 874-4462
Mailing address
10700 E GEDDES AVE, STE 200, ENGLEWOOD, CO 80112-3800
(303) 761-9190
(720) 874-4462
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL18706
OR
2085R0202X
Diagnostic Radiology Physician
04-39604
KS
2085R0202X
Diagnostic Radiology Physician
Primary
113466
CA
2085R0202X
Diagnostic Radiology Physician
29776
NE
2085R0202X
Diagnostic Radiology Physician
57945
CO
2085R0202X
Diagnostic Radiology Physician
MD18981
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
56135157
—
CO
Enumeration date
06/03/2009
Last updated
04/07/2017
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