Black, Roger L

Black, Roger L is an individual health care provider with primary practice located at 302 Kensington Ave , Flint MI 48503-2044. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Black, Roger L can be contacted via phone (810) 762-8200.

Contact Information

Primary practice address
302 Kensington Ave Flint MI 48503-2044
Phone: (810) 762-8200
Fax: (810) 762-8202
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 5101006716 Michigan

Profile Details

NPI number 1477518157
LBN Legal business name Black, Roger L
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Sep 22nd, 2011 - about 14 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 1477518157 NPPES
Michigan MEDICAID 111324694

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