SearchGeorgia213ES0103X

Trevor Black, D.P.M

NPI 1861835308 · on the registry since 2013

Practice

Address
20 Glenlake Pkwy
Kaiser Permanente Glenlake Medical Center
Atlanta, GA 30328
Phone
(818) 326-1058
Organisation at this address
Kaiser Foundation Health Plan Of Georgia, Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
117

Registry record

Primary taxonomy
213ES0103X
213ES0103X
Also registered as
390200000X
Licence states on file
GA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2022-01-10

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 Georgia