| NPI | 1174042022 |
|---|---|
| Doing Business As | KIDMED STAFFORD |
| Entity Type | Organization |
| Authorized Contact | MARK A FLANZENBAUM President 804-592-5437 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2023-08-30 |