Black, Tracy M
Black, Tracy M is an individual health care provider with primary practice located at 4220 N Roxboro St , Durham NC 27704-1826. She recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as her primary health care specialty. Black, Tracy M can be contacted via phone (919) 471-1518.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism | 207RE0101X | 9400724 | North Carolina |
Profile Details
| NPI number | 1700853660 |
|---|---|
| LBN Legal business name | Black, Tracy M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 1st, 2006 |
| Last updated | Jan 30th, 2013 - about 11 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 | 1700853660 | NPPES |
| North Carolina | MEDICAID | 8912086 | |
| North Carolina | Other | P00163549 | |
| North Carolina | Other | 2337913 | |
| North Carolina | Other | 4646370 | |
| North Carolina | Other | 12086 |
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