NPI 1104833904

Jerrold G Black, MD

Practitioner Family Medicine Physician Woodbridge, VA

Practice location

Address: 4167 Merchant Plz, Woodbridge, VA 22192-5088
Phone: (703) 878-8800
Fax: (703) 878-2133

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 01063821A (IN)

Other Family Medicine providers in Virginia →

Registry record

NPI: 1104833904
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Aug 2006
Record last updated: 28 Feb 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.