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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 CifInferred 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
- Medical Physician Assistant
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