Andrew P Black PA - C

NPI 1790011724 - Physician Assistant - 363AM0700X

NPI Details
NPI 1790011724
Gender Male
Enumeration Date 10/27/2009
Last Updated 01/25/2010
Entity Type Individual
Active Over 7 years ago
Practice Location
2912 SPRINGBORO W
SUITE 201
MORAINE OH, 45439-1674, US
Phone (937) 297-8999
Fax (937) 237-6179
Business Location
2248 WHITLOCK PL
KETTERING OH, 45420-1364, US
Phone (937) 219-4972
Fax
Toxanomy
Taxonomy Code 363AM0700X
License State Ohio
License Number 50-002937
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According to our database, Mr. Andrew P Black PA - C NPI is 1790011724, taxonomy code is 363AM0700X and license number is 50-002937, license state is located at Ohio. Andrew P Black PA - C physically located at 2912 Springboro W, Moraine OH, 45439-1674. NPI Number Andrew P Black PA - C has the Individual type.

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1790011724 NPI number is provided on an as is basis without warranty of any kind. 1790011724 is maintained by the National Plan & Provider Enumeration System. The contents of Andrew P Black PA - C are for informational purposes only.