National Provider Identifier Database

BLACK PETERSON, CNIM – NPI #1447833173
Clinical Neurophysiology

Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS).


Contact Information

BLACK PETERSON, CNIM
1304 SUNSET BLVD # 203
WEST COLUMBIA, SC29169-5914
Phone: 888-851-3677
Fax:
Website:
Specialty Taxonomy Code
* Clinical Neurophysiology 2084N0600X

* Indicates primary specialty

NPI Profile & details for BLACK PETERSON

NPI Number 1447833173
Credentials CNIM
Entity Individual
Enumeration date 04/30/2021
Last updated 04/30/2021 - About 5 years ago
Sole proprietor1 No
Identifiers
  • SC License #: 4700
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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