DR. EVAN H BLACK (NPI# 1932185089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932185089 |
| Entity Type | Individual |
| Full Name | DR. EVAN H BLACK |
| Credential | MD |
| Practice Address |
4717 St. Antoine Kresge Eye Institute Detroit MI 48201-1423 |
| Mailing Address |
1560 E Maple Rd Suite 400-credentialing Troy MI 48083-1138 |
| Practice Telephone | 3135778900 |
| Practice Fax Number | 3135770700 |
| Mailing Telephone | 3135778900 |
| Mailing Fax Number | 3135770700 |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2016-10-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 4301071533 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3462161 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316599020 | Evan Michael Black | Dentist | 200 Mercy Cir, Building H-200 4th Floor, Fpo, AA 92055 | 2019-07-12 |
| 1346260247 | Evan G Black | Psychiatry & Neurology | 5323 Woodrow St, #201, Murray, UT 84107-5841 | 2006-07-20 |
| Street Address |
4717 ST. ANTOINE KRESGE EYE INSTITUTE |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-1423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043566318 | Sura Hassan | Optometrist | 4717 St. Antoine, Kresge Eye Institute, Detroit, MI 48201-1423 | 2012-07-24 |
| 1982880605 | Johnstone Minsok Kim | Ophthalmology | 4717 St. Antoine, Kresge Eye Institute, Detroit, MI 48201-1423 | 2008-01-11 |
| 1417150681 | Kamal Fahim | Ophthalmology | 4717 St. Antoine, Kresge Eye Institute, Detroit, MI 48201-1423 | 2007-06-06 |
| 1801955851 | John R. Suchomel | Ophthalmology | 4717 St. Antoine, Detroit, MI 48201-1423 | 2006-12-06 |
| 1235140377 | Ray S Dixon | Ophthalmology | 4717 St. Antoine, Kresge Eye Institute, Detroit, MI 48201-1423 | 2006-08-11 |
| 1982613642 | Allan Richard Rinke Jr. | Ophthalmology | 4717 St. Antoine, Kresge Eye Institute, Detroit, MI 48201-1423 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
| Find all providers in zip 48201 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780779678 | Otis B. Ferguson IIi Md PC | Ophthalmology | 7633 East Jefferson, Suite 120, Detroit, MI 48214 | 2006-10-04 |
| 1912008566 | Dennis C Woods Sr. | Ophthalmology | 4727 St Antoine St, Suite 207, Detroit, MI 48201 | 2006-09-26 |
| 1689685976 | Associated Eye Institutes of Detroit, PC | Ophthalmology | 65 Cadillac Sq, Ste 105, Detroit, MI 48226-2844 | 2006-08-11 |
| 1245248129 | W Anthony Greer | Ophthalmology | 7733 East Jefferson, Detroit, MI 48214 | 2006-08-04 |
| 1952348443 | Gabriel Sosne | Ophthalmology | 4717 St Antoine, Kresge Eye Institute, Detroit, MI 48201-1423 | 2006-06-01 |
| 1609813120 | Anju Goyal | Ophthalmology | Kresge Eye Institute, 4717 St Antoine, Detroit, MI 48201 | 2006-06-01 |
| 1053388074 | William Robert Lucas Jr. | Ophthalmology | 4717 Saint Antoine St, Kresge Eye Institute, Detroit, MI 48201-1423 | 2006-03-08 |
| 1033104773 | Daniel Seth Zuckerbrod | Ophthalmology | 14400 West Mcnichols, Detroit, MI 48235-3916 | 2005-09-20 |
| 1235796780 | John Michael Guest | Ophthalmology | 4717 Saint Antoine St, Detroit, MI 48201-1423 | 2019-05-21 |
| 1043877616 | Hassan Ali Tokko | Ophthalmology | 4717 Saint Antoine St, Detroit, MI 48201-1423 | 2019-05-20 |
| Find all providers in DETROIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.