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:
Health care specialties
Specialty | Code | License # | 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 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1932185089 | NPPES |
Michigan | MEDICAID | 3462161 |
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