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:
Health care specialties
| Specialty | Code | License # | 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 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477518157 | NPPES |
| Michigan | MEDICAID | 111324694 |
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