NPI | 1023318383 |
---|---|
Doing Business As | ANMED PRIMARY CARE - LAKESIDE |
Entity Type | Organization |
Authorized Contact | STEPHEN JAN GRISGBY C Fo 864-512-1109 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2010-11-02 |
Last Update Date | 2025-05-23 |