| NPI | 1003448952 |
|---|---|
| Doing Business As | MGT MD AT HOME |
| Entity Type | Organization |
| Authorized Contact | JAMEELAH WILSON Owner 480-430-0721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2020-02-09 |
| Last Update Date | 2020-02-09 |