Black, Matthew Wade

Black, Matthew Wade is an individual health care provider with primary practice located at 607 W Main St , Grangeville ID 83530-1345. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Black, Matthew Wade can be contacted via phone (208) 983-1700.

Contact Information

Primary practice address
607 W Main St Grangeville ID 83530-1345
Phone: (208) 983-1700
Fax: (208) 983-4665
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA-2620 Idaho

Profile Details

NPI number 1891415063
LBN Legal business name Black, Matthew Wade
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2022
Last updated Oct 25th, 2023 - about last year

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.

Request for update

Popular Providers