| NPI | 1003202524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAIJU SHETH Mbr 636-212-0667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: FL ME101617) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME101617) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME101617) | |
| 207R00000X Internal Medicine (Licence: FL ME101617) | |
| 208M00000X Hospitalist (Licence: FL ME101617) | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2015-04-10 |