Black, Mike A

Black, Mike A is an individual health care provider with primary practice located at 4989 S State St Unit 57768 , Salt Lake City UT 84157-5032. He recently has 3 registered licenses in different health care specialties including Emergency Medical Service Providers / Emergency Medical Technician, Basic, Technologists, Technicians & Other Technical Service Providers / Technician, Cardiology, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Black, Mike A can be contacted via phone (916) 217-1584.

Contact Information

Primary practice address
4989 S State St Unit 57768 Salt Lake City UT 84157-5032
Phone: (916) 217-1584
Fax: (866) 722-1584
Website:
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Health care specialties

SpecialtyCodeLicense #State
Emergency Medical Service Providers / Emergency Medical Technician, Basic 146N00000X E1160515
Technologists, Technicians & Other Technical Service Providers / Technician, Cardiology 246W00000X 60434882 Washington
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology 207RC0001X 161255 District of Columbia

Profile Details

NPI number 1942716998
LBN Legal business name Black, Mike A
Credentials CEPS, NREMT
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2017
Last updated May 3rd, 2019 - about 5 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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