NPI | 1316024128 |
---|---|
Doing Business As | PMG SOUTH MEDFORD PEDIATRICS |
Entity Type | Organization |
Authorized Contact | DONALD W ANDERSON Dir Reimb Reg Strat/Asst Sec Enroll 425-525-5392 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261Q00000X |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2006-11-01 |
Last Update Date | 2021-06-15 |