Black, Steven Edward
Black, Steven Edward is an individual health care provider with primary practice located at 200 W Academy Street , Gainesville GA 30501. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Black, Steven Edward can be contacted via phone (770) 282-8820.Contact Information
Primary practice address
200 W Academy Street
Gainesville GA 30501
Phone: (770) 282-8820
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 045727 | Georgia |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 045727 | Georgia |
Profile Details
| NPI number | 1609808369 |
|---|---|
| LBN Legal business name | Black, Steven Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2006 |
| Last updated | Jan 12th, 2021 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609808369 | NPPES |
| Georgia | MEDICAID | 000798971G | |
| Georgia | MEDICAID | 000798971K | |
| Georgia | Other | P00332154 | |
| Georgia | Other | 581177261A |
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