| NPI | 1356650493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTY A BLAYLOCK Credentialing COO Rdinator 440-892-6406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2010-10-06 |