| NPI | 1073854600 |
|---|---|
| Doing Business As | MIDC, LLC |
| Entity Type | Organization |
| Authorized Contact | TARA KOWALSKI Credentialing Manager 888-220-6432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine Infectious Disease |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2022-07-21 |