NPI | 1013790393 |
---|---|
Doing Business As | LCH-INTERNAL MEDICINE MATTHEW DRIVE |
Entity Type | Organization |
Authorized Contact | JOSEPH NIEBERGALL Credentialing Specialist 239-424-1446 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Enumeration Date | 2023-08-18 |
Last Update Date | 2023-09-14 |