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 |