NPI | 1396399796 |
---|---|
Doing Business As | SSM HEALTH MEDICAL GROUP SLEEP DISORDERS |
Entity Type | Organization |
Authorized Contact | CRYSTAL L PENA Provider Enrollment/Credentialing 405-272-7452 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207RS0012X Internal Medicine, Sleep Medicine |
Additional Taxonomies | 207QS1201X Family Medicine, Sleep Medicine |
Enumeration Date | 2019-07-25 |
Last Update Date | 2019-07-25 |