NPI | 1104471622 |
---|---|
Doing Business As | SMG OB ON CENTRAL |
Entity Type | Organization |
Authorized Contact | DEBORAH CAPUTO Credentialing Manager 773-257-2905 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics |
Enumeration Date | 2019-08-02 |
Last Update Date | 2019-08-02 |