NPI 1346260247 · live from the CMS NPI Registry
Evan George Black, M.D.
Psychiatry & Neurology, Neurology in Murray, UT. National Provider Identifier 1346260247, active.
NPI record
| NPI | 1346260247 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Neurology 2084N0400X |
| Practice location | 5323 Woodrow St, #201, Murray, UT 84107 |
| Practice phone | 801-261-4711 |
| Enumerated | July 20, 2006 |
| Last updated | January 3, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Neurology | 2084N0400X | MD476184 (PA) |
| Psychiatry & Neurology, Neurology | 2084N0400X | 187597-1205 (UT) |
| Psychiatry & Neurology, Neurology | 2084N0400X | 21619 (NH) |
| Psychiatry & Neurology, Neurology | 2084N0400X | 99622 (MT) |
| Psychiatry & Neurology, Neurology | 2084N0400X | 89191 (GA) |
| Psychiatry & Neurology, Neurology primary | 2084N0400X | MD205738 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.