| NPI | 1366644577 |
|---|---|
| Doing Business As | SAINTS AT SHEPHERD MALL |
| Entity Type | Organization |
| Authorized Contact | SYNOVIA F BAIN Client Account Administrator 405-231-3824 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2007-08-08 |