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Search › Idaho › 363AM0700X

Matthew Black, PA

NPI 1891415063 · on the registry since 2022

Practice

Address
607 W Main St
Grangeville, ID 83530
Phone
(208) 983-1700
Fax
(208) 983-4665
Organisation at this address
Cardinal Health 132, Llc
Syringa General Hospital
Syringa Hospital Ddp Program
Syringa Hospital Childrens Ddp
Syringa General Hospital District Cif
Inferred from a shared address, not stated in the registry.
Clinicians at this address
19

Additional practice sites

  • 22 N Main St, Kooskia, ID

Registry record

Primary taxonomy
363AM0700X
363AM0700X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2023-10-25

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho