NPI | 1144836206 |
---|---|
Doing Business As | SSM HEALTH MEDICAL GROUP WOMENS HEALTH EAST |
Entity Type | Organization |
Authorized Contact | CRYSTAL L PENA Provider Enrollment Co Ordinator 405-272-7452 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
Enumeration Date | 2020-09-23 |
Last Update Date | 2021-08-11 |