Black, Evan H

Black, Evan H is an individual health care provider with primary practice located at 4717 St. Antoine Kresge Eye Institute, Detroit MI 48201-1423. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Black, Evan H can be contacted via phone (313) 577-8900.

Contact Information

Primary practice address
4717 St. Antoine Kresge Eye Institute Detroit MI 48201-1423
Phone: (313) 577-8900
Fax: (313) 577-0700
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery 207WX0200X 4301071533 Michigan

Profile Details

NPI number 1932185089
LBN Legal business name Black, Evan H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 21st, 2005
Last updated Sep 17th, 2021 - about 5 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 1932185089 NPPES
Michigan MEDICAID 3462161

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