| NPI | 1184174252 |
|---|---|
| Doing Business As | SCMG BREAST HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | MARCIA T POLHEMUS Controller 401-788-1974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2020-08-03 |