Black, Trevor Elan
Black, Trevor Elan is an individual health care provider with primary practice located at 20 Glenlake Pkwy Kaiser Permanente Glenlake Medical Center, Atlanta GA 30328-3473. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Black, Trevor Elan can be contacted via phone (818) 326-1058.Contact Information
Primary practice address
20 Glenlake Pkwy Kaiser Permanente Glenlake Medical Center
Atlanta GA 30328-3473
Phone: (818) 326-1058
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | POD001289 | Georgia |
Profile Details
NPI number | 1861835308 |
---|---|
LBN Legal business name | Black, Trevor Elan |
Credentials | Doctor of Podiatric Medicine (DPM) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 15th, 2013 |
Last updated | Jan 10th, 2022 - about 2 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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