Matthew Wade Black, PA
Matthew Wade Black, PA is a Physician Assistant in Grangeville, Idaho. Qualified in 2023, 3 years ago. Practices with Syringa General Hospital District C I F, a 20-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.
- Years since qualifying
- 3
- Licensed in
- ID
- In the registry since
- 2022
What do these letters mean?
- PA — Physician Assistant
- A licensed clinician who examines, diagnoses and treats under a physician's supervision.
Practice location Address checks out
607 W Main StGrangeville, ID 83530-1345
Phone: (208) 983-1700
Fax: (208) 983-4665
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 22 N Main St, Kooskia, ID 83539 — (208) 926-4776
Specialties & licences
| Medical Physician Assistant (primary) | Taxonomy 363AM0700X · Licence PA-2620 (ID) |
|---|
Record details
| NPI number | 1891415063 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PA |
| Sole proprietor | No |
| NPI enumerated | August 29, 2022 |
| Last updated in NPPES | October 25, 2023 |
| Certification date | October 24, 2023 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2023 (3 years in practice) |
| Group practice | Syringa General Hospital District C I F — 20 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Grangeville
-
Bradi Morel Voigt Trapp, PA-C
607 W Main St, Grangeville, ID 83530-1345 · (208) 983-8590
-
Mr. Derek R Wynn, PA
607 W Main St, Grangeville, ID 83530 · (208) 983-1700