Black, Dalliah Mashon

Black, Dalliah Mashon is an individual health care provider with primary practice located at 200 1St St Sw , Rochester MN 55905-0001. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Oncology. Allopathic & Osteopathic Physicians / Surgery is her primary health care specialty. Black, Dalliah Mashon can be contacted via phone (507) 284-2511.

Contact Information

Primary practice address
200 1St St Sw Rochester MN 55905-0001
Phone: (507) 284-2511
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 223910 Massachusetts
Allopathic & Osteopathic Physicians / Surgery 208600000X 044471 Connecticut
Allopathic & Osteopathic Physicians / Surgical Oncology 2086X0206X 43694 Texas
Allopathic & Osteopathic Physicians / Surgery 208600000X 74430 Minnesota

Profile Details

NPI number 1295725794
LBN Legal business name Black, Dalliah Mashon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2005
Last updated Sep 27th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295725794 NPPES
Massachusetts Other J28934 BCBS MA
Massachusetts MEDICAID 286882001 (MDACC) BCBS MA
Massachusetts Other 468419 BCBS MA
Massachusetts Other 8DB287 BCBS MA

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