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 |