Black, John William

Black, John William is an individual health care provider with primary practice located at 3623 Latrobe Dr Suite 216, Charlotte NC 28211. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Black, John William can be contacted via phone (704) 332-1291.

Contact Information

Primary practice address
3623 Latrobe Dr Suite 216 Charlotte NC 28211
Phone: (704) 332-1291
Fax: (704) 332-5206
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 27821 South Carolina
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 96-01000 North Carolina

Profile Details

NPI number 1023092095
LBN Legal business name Black, John William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2005
Last updated Sep 13th, 2020 - 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 1023092095 NPPES
North Carolina MEDICAID 891010R

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