| NPI | 1063955425 |
|---|---|
| Doing Business As | DAVITA MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | JOHN G. LIETHEN Secretary 952-205-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Enumeration Date | 2016-12-02 |
| Last Update Date | 2019-08-20 |