Black, Steven R

Black, Steven R is an individual health care provider with primary practice located at 405 W Country Club Rd , Roswell NM 88201-5209. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Black, Steven R can be contacted via phone (575) 624-2095.

Contact Information

Primary practice address
405 W Country Club Rd Roswell NM 88201-5209
Phone: (575) 624-2095
Fax: (575) 208-0780
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD2011-0547 New Mexico
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD2011-0547 New Mexico

Profile Details

NPI number 1578546438
LBN Legal business name Black, Steven R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2005
Last updated Oct 21st, 2022 - about 4 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 1578546438 NPPES
New Mexico MEDICAID 66933862

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