Mr Shawn Michael Black, MS, PT is a
Physical Therapist physician based in Traverse City, Michigan. Mr Shawn Michael Black is licensed to practice in Michigan (license number 5501011285) and his current practice location is 701 Us Highway 31 S, Traverse City, Michigan. He can be reached at his office (for appointments etc.) via phone at
(800) 406-5143.
NPI number for Mr Shawn Michael Black is 1679603575 and his current mailing address is 1189 Gonder Rd, Interlochen, Michigan. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1679603575.
Physician's Profile
| Full Name | Mr Shawn Michael Black |
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| Gender | Male |
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| Speciality | Physical Therapist |
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| Location | 701 Us Highway 31 S, Traverse City, Michigan |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1679603575
- Provider Enumeration Date: 03/07/2007
- Last Update Date: 05/07/2025
Medical Identifiers
Medical identifiers for Mr Shawn Michael Black such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1679603575 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208100000X | Physical Medicine & Rehabilitation | 5501011285 (Michigan) | Secondary |
| 225100000X | Physical Therapist | 5501011285 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Shawn Michael Black is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Shawn Michael Black, MS, PT
1189 Gonder Rd,
Interlochen, MI 49643-9705
Ph: () - | Mr Shawn Michael Black, MS, PT
701 Us Highway 31 S,
Traverse City, MI 49685-8016
Ph: (800) 406-5143 |
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