| NPI | 1205476819 |
|---|---|
| Doing Business As | SSM HEALTH MEDICAL GROUP CROSSWAYS |
| Entity Type | Organization |
| Authorized Contact | CRYSTAL L PENA Provider Credentialing Coordinator 405-272-7452 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2020-01-11 |
| Last Update Date | 2020-01-11 |