| NPI | 1306496641 |
|---|---|
| Doing Business As | MARTIN LUTHER KING JR. COMMUNITY MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | KURT STAUDER President 424-529-6755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 171R00000X Interpreter | |
| 176B00000X Midwife | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine | |
| 208000000X Pediatrics | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2024-05-14 |