Black, Michelle T

Black, Michelle T is an individual health care provider with primary practice located at 10700 E Geddes Ave Suite 200, Englewood CO 80112-3800. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is her primary health care specialty. Black, Michelle T can be contacted via phone (303) 761-9190.

Contact Information

Primary practice address
10700 E Geddes Ave Suite 200 Englewood CO 80112-3800
Phone: (303) 761-9190
Fax: (720) 874-4462
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X LL18706 Oregon
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD18981 Hawaii
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 113466 California
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 29776 Nebraska
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 04-39604 Kansas
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 57945 Colorado

Profile Details

NPI number 1972739001
LBN Legal business name Black, Michelle T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2009
Last updated Apr 7th, 2017 - about 7 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 1972739001 NPPES
Colorado MEDICAID 56135157

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