| NPI | 1326184334 |
|---|---|
| Doing Business As | OB/GYN SPECIALTY GROUP/NORTHEAST PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | ANDREW H. GRIMM Executive Director 660-627-5757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO R5810) |
| 207V00000X Obstetrics & Gynecology (Licence: MO 2004027805) | |
| 207V00000X Obstetrics & Gynecology (Licence: MO 2009006697) | |
| 208000000X Pediatrics (Licence: MO 2006022612) | |
| 208000000X Pediatrics (Licence: MO 2005037590) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MO 2009001623) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2012-10-30 |