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1316028103
RICHARD E BLACK
SALT LAKE CITY, UT
NPI
1316028103
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2086S0120X Surgery, Pediatric Surgery
(Licence: UT 1597211205)
Enumeration Date
2006-10-18
Last Update Date
2013-12-03
Business Address
-- RICHARD E BLACK MD
100 MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113-1103
Phone number: 801-662-2950
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Mailing Address
-- RICHARD E BLACK MD
PO BOX 413035
SALT LAKE CITY, UT 84141-3035
Phone number: 801-213-3900
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