Black, David Michael
Black, David Michael is an individual health care provider with primary practice located at 625 9Th Ave Ste 210, Longview WA 98632-2465. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Hand Surgery. Allopathic & Osteopathic Physicians / Hand Surgery is his primary health care specialty. Black, David Michael can be contacted via phone (360) 501-3400.Contact Information
Primary practice address
625 9Th Ave Ste 210
Longview WA 98632-2465
Phone: (360) 501-3400
Fax: (360) 423-6862
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | MD00023497 | Washington |
| Allopathic & Osteopathic Physicians / Hand Surgery | 207XS0106X | MD00024397 | Washington |
Profile Details
| NPI number | 1245205228 |
|---|---|
| LBN Legal business name | Black, David Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 22nd, 2006 |
| Last updated | Apr 7th, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245205228 | NPPES |
| Washington | MEDICAID | 1014117 | |
| Washington | MEDICAID | 178434 |
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