NPI 1023092095 · live from the CMS NPI Registry
John William Black, M.D.
Radiology, Diagnostic Radiology in Charlotte, NC. National Provider Identifier 1023092095, active.
NPI record
| NPI | 1023092095 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 3623 Latrobe Dr, Suite 216, Charlotte, NC 28211 |
| Practice phone | 704-332-1291 |
| Mailing address | Po Box 221249, Charlotte, NC 28222 |
| Enumerated | December 2, 2005 |
| Last updated | September 13, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Radiology, Diagnostic Radiology | 2085R0202X | 27821 (SC) |
| Radiology, Diagnostic Radiology primary | 2085R0202X | 96-01000 (NC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.