| Matthew Wade Black, PA | |
|
607 W Main St, Grangeville, ID 83530-1345 | |
| (208) 983-1700 | |
| (208) 983-4665 |
| Full Name | Matthew Wade Black |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant - Medical |
| Location | 607 W Main St, Grangeville, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891415063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | PA-2620 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew Wade Black, PA 607 W Main St, Grangeville, ID 83530-1345 Ph: (208) 983-1700 | Matthew Wade Black, PA 607 W Main St, Grangeville, ID 83530-1345 Ph: (208) 983-1700 |
Mr. Derek R Wynn, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 607 W Main Street, Grangeville, ID 83530 Phone: 208-983-1700 Fax: 208-983-4665 | |
Mr. Nathan T Winder, MHS PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 607 W Main St, Grangeville, ID 83530 Phone: 208-983-8590 | |
Bradi Morel Voigt Trapp, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 607 W Main St, Grangeville, ID 83530 Phone: 208-983-8590 | |
Paul Edward Macmillan, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 607 W Main St, Grangeville, ID 83530 Phone: 208-983-8590 |