Jerrold G Black, MD

NPI #1104833904 in Woodbridge, Virginia

Provider Information

NPI Number: 1104833904
Entity Type: Individual
Name: Jerrold G Black, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: MD
Enumeration Date: Aug 2, 2006
Last Updated: Feb 28, 2011

Practice Location

Address: 4167 MERCHANT PLZ
City: Woodbridge
State: Virginia
ZIP Code: 22192-5088
Phone: (703) 878-8800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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