Black Peterson, CNIM
Black Peterson, CNIM is a Clinical Neurophysiology Physician in West Columbia, South Carolina. Licensed in South Carolina. Registered with an NPI since 2021.
- Licensed in
- SC
- In the registry since
- 2021
Practice location Address checks out
1304 Sunset Blvd # 203West Columbia, SC 29169-5914
Phone: (888) 851-3677
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Specialties & licences
| Clinical Neurophysiology Physician (primary) | Taxonomy 2084N0600X · Licence 4700 (SC) |
|---|
Record details
| NPI number | 1447833173 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | CNIM |
| Sole proprietor | No |
| NPI enumerated | April 30, 2021 |
| Last updated in NPPES | April 30, 2021 |
| Certification date | April 30, 2021 |
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April Driggers, CNIM
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Ayla Vansickle, CNIM
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