| NPI | 1114322575 |
|---|---|
| Doing Business As | WELLPOINT MEDICAL SERVICES, PC |
| Entity Type | Organization |
| Authorized Contact | ANTHONY T SECURO Medical Director 478-328-6466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: GA 051736) |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2014-12-29 |