Most Relevant Information
Provider Data
| NPI Number: | 1003007311 |
| Provider Name: | MICHAEL ANTHONY BLACK P.A.-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA10004010 |
Most Important Dates
| Enumeration Date: | 08/05/2007 |
| Last Updated: | 10/31/2024 |
Provider Practice Location
1762 E MAIN ST
SPARTANBURG
SC
293072231
Practice Location Phone/Fax
| Phone: | 8645912261 |
| Fax: |
Provider Mailing Location
PO BOX 749306
ATLANTA
GA
303749306
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |