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Contact Information

EVAN H BLACK, MD
4717 ST. ANTOINE
KRESGE EYE INSTITUTE
DETROIT, MI48201-1423
 Phone: 313-577-8900
 Fax: 313-577-0700
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmic Plastic and Reconstructive Surgery

207WX0200X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for EVAN H BLACK · (Male)

NPI # 1932185089
Status Active
Credentials MD
Entity Individual
Enumeration date 12/21/2005
Last updated 06/05/2025 - About 12 months ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301071533
  • MI Medicaid 3462161
Hospital affiliation(s)
  • WILLIAM BEAUMONT HOSPITAL - (Acute Care)
    3601 W THIRTEEN MILE RD
    ROYAL OAK, MI 48073
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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