| NPI | 1225096472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA MUSIC Director Provider Enrollment 877-892-9815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207LP2900X Anesthesiology, Pain Medicine | |
| 207R00000X Internal Medicine | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 207RS0012X Internal Medicine, Sleep Medicine | |
| 207X00000X Orthopaedic Surgery | |
| 207Y00000X Otolaryngology | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 208600000X Surgery | |
| 208M00000X Hospitalist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2025-07-09 |