| 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 Clinic/Center |
| 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 |