NPI | 1255786703 |
---|---|
Doing Business As | PANGEA MEDICAL |
Entity Type | Organization |
Authorized Contact | STEVEN R BLACK Managing Member 575-624-2095 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM MD2011-0547) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2011-0547) |
Enumeration Date | 2016-05-03 |
Last Update Date | 2022-10-21 |