MICHAEL JASON BLACK

APPLETON, WI
NPI1720036387
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208600000X Surgery
(Licence: WI  46688-020)
Additional Taxonomies208600000X Surgery
(Licence: WI  46688)
Enumeration Date2006-05-05
Last Update Date2008-10-27
Business Address
-- MICHAEL JASON BLACK M.D.
1818 N MEADE ST SUITE 240 WEST
APPLETON, WI 54911-3496
Phone number: 920-731-8131
Mailing Address
-- MICHAEL JASON BLACK M.D.
1818 N MEADE ST SUITE 240 WEST
APPLETON, WI 54911-3496
Phone number: 920-731-8131
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