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:
Health care specialties
| Specialty | Code | License # | 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 3 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.
Popular Providers
-
Park, Daniel
1441 Eastlake Ave Ste 7416, Los Angeles CA 90089-2211 -
Preciado, Richard
1516 San Pablo St Fl 5 , Los Angeles CA 90033-5313 -
Harrington, Jennifer L.
841 S Highway 25 W # S Suite 5, Williamsburg KY 40769-4600 -
Stewart, Susan S
Maui Medical Group 2180 Main Street, Wailuku HI 96793 -
Costello, Daniel G
1526 Cole Blvd Ste 300 , Lakewood CO 80401-3410 -
Kahng, Pauline
275 Route 30 N , Bomoseen VT 05732-9647 -
Welch, Kathryn A
220 S Hillside St Ste A , Wichita KS 67211-2151 -
Engle, Jocelyn J
30 Community Dr , Easton PA 18045-2658