NPI | 1083959522 |
---|---|
Doing Business As | PROMEDICA CHILDREN'S SPECIALTIES |
Entity Type | Organization |
Authorized Contact | KRISTIN KNUEVEN Credentialing Supervisor 567-585-1969 |
Organization Subpart ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology |
Enumeration Date | 2012-12-11 |
Last Update Date | 2021-02-05 |